RESUMEN
Objective:To investigate the clinical effect of vortioxetine in the treatment of patients with first-episode depression.Methods:From January 2018 to January 2019, 100 patients with depression in outpatients or inpatients of Wenzhou Kangning Hospital were enrolled in the study.According to different treatment methods, they were divided into control group and observation group according to the random digital table method, with 50 cases in each group.The control group was given fluoxetine 20-40mg, qd, and the observation group was treated with vortioxetine.Both two groups were treated for 8 weeks.The pre-treatment subjective cognitive function of the two groups was evaluated.Brain-derived neurotrophic factor(BDNF), homocysteine (Hcy), tumor necrosis factorα(TNF-α), 1, 25-hydroxyl vitamin D 3[1, 25-(OH) 2D 3] were detected in two groups.The electrophysiological indicators event-related potential P300 were detected.The Hamilton Depression Scale(HAMD) was used to evaluate the mental anxiety, mood and physical anxiety of patients before and after treatment in the two groups.The clinical effects of the two groups were evaluated and the adverse reactions were recorded. Results:After treatment for 4 weeks and 8 weeks, the cognitive function scores of the control group were (24.96±2.85)points and (26.18±3.16)points, respectively, which of the observation group were (28.65±3.32)points and (32.66±3.81)points, respectively, which were significantly higher than before treatment(control group: F=14.821; observation group: F=10.632, all P<0.01). The cognitive function scores of the two groups after treatment for 8 weeks were significantly higher than treatment for 4 weeks (control group: t=2.027, P=0.045, observation group: t=5.611, P=0.000). After treatment, the levels of BDNF, Hcy, TNF-α, 1, 25-(OH) 2D 3 in the control group were (29.74±3.62)ng/L, (18.46±2.34)μmol/L, (314.11±15.87)ng/L, (30.69±4.17)ng/mL, respectively, which in the observation group were (34.22±2.85)ng/L, (14.55±2.17)μmol/L, (286.55±10.11)ng/L, (34.92±4.28)ng/m, respectively, the differences between the two groups were statistically significant( t=6.876, 8.663, 10.357, 5.005, all P<0.01). After treatment, the P300 latency and P300 amplitude of the control group were (426.94±4.72)ms, (0.62±-4.31)μV, respectively.which of the observation group were (413.65±3.66)ms, (0.84±-4.76)μV, respectively, the differences between the two groups were statistically significant( t=15.734, 3.048, all P<0.01). After treatment, the HAMD score of the observation group[(10.72±1.53) points] was significantly lower than that of the control group[(12.93±1.84)points]( t=6.530, P<0.01). The effective rate of the observation group was 88.0%(44/50), which of the control group was 86.0%(43/50), the difference between the two groups was not statistically significant( P>0.05). Conclusion:The application of vortioxetine in the treatment of patients with first-episode depression can improve the cognitive function and clinical symptoms of patients, and can also reduce the biochemical indicators of patients.However, the therapeutic effect is similar to that of fluoxetine, but it has less adverse reactions, so it is worthy of promoting.