摘要

探讨氟伏沙明联合辩证行为治疗伴有非自杀性自伤行为（nonsuicidal self-injury，NSSI）的青少年抑郁症的效果。

方法 回顾性收集绵阳市第三人民医院2021年1月至2023年4月期间收治的102例伴有NSSI的青少年抑郁症患者的临床资料，经纳排标准剔除12例后，最终选取90例作为研究对象。根据治疗方案将患者分为对照组（n=43）和试验组（n=47），对照组采用氟伏沙明治疗，试验组在此基础上联合辩证行为疗法治疗。比较两组疗效、神经递质[β内啡肽（β-endorphin，β-EP）、神经生长因子（nerve growth factor，NGF）、5-羟色胺（5-hydroxytryptamine，5-HT）]、炎症因子[白介素（interleukin，IL）-10、巨噬细胞迁移抑制因子（macrophage migration inhibitory factor，MIF）]、情绪[汉密尔顿抑郁量表（Hamilton Depression Rating Scale，HAMD）]、自伤行为[渥太华自我伤害调查表(Ottawa Self-Injury Inventory，OSI)]、睡眠质量[匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index，PSQI）]、生活质量[生活质量综合评定问卷（Generic Quality of Life Inventory-74 ，GQOLI-74）]。

结果 试验组的总有效率（95.74%）高于对照组（79.07%）（P＜0.05）。治疗后，两组血清VGF、NGF、5-HT、IL-10升高，MIF下降，且试验组变化幅度大于对照组（P＜0.05）。治疗后，两组HAMD、OSI、PSQI评分下降，GQOLI-74评分上升，且试验组上述评分变化幅度大于对照组（P＜0.05）。

结论 氟伏沙明联合辩证行为治疗伴有NSSI的青少年抑郁症能改善患者神经递质水平，缓解负性情绪，减少自伤行为，改善睡眠和生活质量。

关键词：非自杀性自伤行为；青少年；抑郁症；氟伏沙明；辩证行为治疗

ABSTRACT

To investigate the effect of fluvoxamine combined with dialectical behavior therapy on adolescent depression with non-suicidal self-injury (NSSI).

Methods Clinical data of 102 adolescent depression patients with NSSI admitted to The Third Hospital of Mianyang from January 2021 to April 2023 were retrospectively collected. After excluding 12 cases based on inclusion/exclusion criteria, 90 patients were finally selected as study subjects. The patients were divided into a control group (n=43) and an experimental group (n=47) based on treatment regimens. The control group received fluvoxamine alone, while the experimental group received fluvoxamine combined with dialectical behavior therapy. Efficacy, neurotransmitter levels [β-endorphin (β-EP), nerve growth factor (NGF), 5-hydroxytryptamine (5-HT)], cytokine levels [interleukin (IL)-10, macrophage migration inhibitory factor (MIF)], emotional states [Hamilton Depression Scale (HAMD)], self-injury behaviors [Ottawa Self-Injury Inventory (OSI)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)], and quality of life [Generic Quality of Life Inventory-74 (GQOLI-74)] were compared between the two groups.

Results The total effective rate in the experimental group (95.74%) was higher than that in the control group (79.07%) (P < 0.05). After treatment, serum levels of β-EP, NGF, 5-HT, and IL-10 increased, while MIF decreased in both groups, with greater changes observed in the experimental group (P < 0.05). Post-treatment HAMD, OSI, and PSQI scores decreased, and GQOLI-74 scores increased in both groups, with more significant improvements in the experimental group (P < 0.05).

Conclusion   fluvoxamine combined with DBT improves neurotransmitter levels, alleviates negative emotions, reduces self-injury behaviors, and enhances sleep quality and quality of life in adolescents with depression and NSSI.

Key words: Non-suicidal self-injury; Adolescents; Depression; Fluvoxamine; Dialectical behavior therapy