米氮平治疗神经性厌食症的疗效对照研究

Effect of Mirtazapine in Patients with Anorexia Nervosa

目的:观察米氮平对神经性厌食症的疗效。方法:42例符合CCMD-3神经性厌食症患者被随机分成2组,分别给予米氮平和5-羟色胺再摄取抑制剂(SSRIs)治疗12周,而后随访12周。比较患者治疗前后的体重变化、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评分及药物不良反应。结果:共38 例患者完成治疗全过程,其中米氮平组20例,SSRIs 组18例。在治疗6周时,米氮平组的体重增加大于SSRIs 组,差异有显著性(P<0.01);治疗12周时,两组体重增加值差异没有显著性。治疗后两组HAMD 和HAMA 评分均明显减低(P<0.01),但两组间差异无显著性(P>0.05)。两组均未出现严重的药物不良反应,主要不良反应SSRIs 组为胃肠道不适,米氮平有嗜睡、体重增加等。结论:米氮平能明显提高神经性厌食症患者的食欲和体重,改善焦虑抑郁情绪,依从性好,起效时间早于SSRIs,值得在临床上选用。

Objective：To investigate the efficacy ofmirtazapine in patients with anorexia nervosa..Methods： A randomized, controlled study was undertaken in 42 patients with anorexia nervosa. Subjects were treated with mirtazapine or selective serotonin reuptake inhibitor （SSRIs） for 12 weeks and followed up to 12 weeks. The clinical outcome measures included body weight, Hamilton Depression Scale （HAMD）, Hamilton Anxiety Scale （HAMA） and the side effectsof medications. Results：38 subjects completed the trial, 20 in mirtazapine group, 18 in SSRIs group. The weight gain in mirtazapine group was significantly more that that in SSRIs group at week 6 but the difference was not significant at wcck 12. The scores of AMD and HAMA at cndpoint wcrc significantly lower than those at baseline（P〈0.01）, but the difference between groups was not statistically significant（P〉0.05）. No scvcrc adverse events wcrc observed in both groups. Common side effects of SSRIs wcrc gastrocntcrological discomfort, while those of mirtazapinc included somnolence and weight gain. Conclusion：Mirtazapinc can improve appetite and weight gain in patients with anorexia ncrvosa in addition to relieve anxiety and depression. It is well tolerated and has caller onset of effect than SSRIS.