Objective To compare the difference between monotherapy of estradiol valerate and combination therapy of estradiol valerate with folic acid and vitamin B12 in perimenopausal women with depression. Methods From October 2011 to October 2013, 102 perimenopausal patients with depression were preliminarily screened through Hamilton Depression Scale (HAMD) at the gynecology clinic of our hospital. A random number table was used to di-vide the patients into treatment group and control group. Subjects in the treatment group were treated with estradiol valerate (0.5 mg, p.o., qd), folic acid (0.4 mg, p.o, tid) and vitamin B12 (25μg, p.o, tid) for 21 days. Subjects in the con-trol group were treated with estradiol valerate (0.5 mg, p.o., qd) only. The depression status of patients were evaluated at baseline and 2, 4, 6 and 8 weeks after treatment by HAMD. The number of patients involved in the final efficacy analysis was 35 in each group. Results The HAMD scales of patients in both groups decreased after treatment. The therapeutic effect occurred at 8 weeks after treatment, where the scales of the treatment group and maximum the con-trol group decreased to (5.13 ± 2.15) and (11.78 ± 3.42) respectively. There were statistical differences between the groups (P<0.05). According to the clinical efficacy of both groups, the total effective rate of the treatment group was significantly higher than this of the control group [(85.71%(30/35) vs 65.71%(23/35),χ2=3.81, P=0.042]. No adverse drug reactions were reported. Conclusion Efficacy of combination therapy of estradiol valerate with folic acid and vitamin B12 in perimenopausal women with depression was superior to monotherapy of estradiol valerate.%目的：比较戊酸雌二醇单药或联合叶酸、维生素B12治疗围绝经期妇女抑郁症的疗效。方法选取2011年10月至2013年10月在我院妇科门诊就诊，经汉密尔顿抑郁量表初筛的102例围绝经期抑郁症患者作为初筛合格对象。根据随机数字表随机分为治疗组(52例)和对照组(50例)。治疗组每天口服0.5 mg戊酸雌二醇1次，同时加服0.4 mg叶酸和25μg维生素B12，每日3次，连服21 d；对照组每天口服0.5 mg戊酸雌二醇1次，连服21 d。利用HAMD抑郁量表评估患者在基线时、治疗后第2、第4、第6和第8周的抑郁状态。最终纳入疗效分析者治疗组35例，对照组35例。结果两组治疗后HAMD评分均出现下降。治疗后8周，治疗组的HAMD得分下降至(5.13±2.15)分，对照组下降至(11.78±3.42)分，两组比较差异有统计学意义(P<0.05)。治疗组的总有效率为85.71%(30/35)，高于对照组的65.71%(23/35)，差异有统计学意义(χ2=3.81，P=0.042）。治疗期间两组患者均未报告较为严重的不良反应。结论戊酸雌二醇联合叶酸和维生素B12治疗围绝经期抑郁症疗效优于单用戊酸雌二醇。
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