米氮平与丙米嗪治疗抑郁症伴焦虑症状对照研究

A control study of mirtazapine vs. imipramine in depressive disorder associated with anxious symptoms

目的探讨米氮平与丙米嗪治疗抑郁症伴焦虑症状的疗效及安全性。方法将112例抑郁症伴焦虑症状患者随机分为两组各56例，研究组给予米氮平30～45mg·d^-1治疗，对照组给予丙米嗪100～200mg·d^-1治疗，疗程6w。采用汉密顿抑郁量表、汉密顿焦虑量表及副作用量表评定临床疗效及不良反应。结果治疗6w末，抗抑郁治疗研究组显效率为73．2％，对照组为67．3％，两组差异无显著性（P〉0．05）；抗焦虑治疗研究组显效率为78．8％，对照组为43．6％，两组差异有显著性（P〈0．05）。副作用量表评定两组差异无显著性（P〉0．05）。结论米氮平具有抗抑郁抗焦虑双重作用，抗抑郁作用与丙米嗪相当，抗焦虑作用优于丙米嗪，治疗抑郁症伴焦虑症状疗效显著，安全性高、依从性好。

Objective To explore the clinical effects and adverse reactions of mirtazapine vs. imipramine in the treatment of depression associated with anxious symptoms. Methods 112 depressive patients associated with anxious were randomly divided into research group（n=56, took mirtazapine 30～45mg/d） and control group（n= 56, did imipramine 100～200mg/d） for 6 weeks. The clinical effects and adverse reactions were assessed with the HAMD,HAMA and TESS, respectively. Results At the end of 6th week, effectual rates were respectively 73. 2% in the antidepressive research group and 67. 3% in the control group, which showed no significant difference（P〉0.05） ; effectual rates were respectively 78.8% in the antianxious research group and 43.6% in the control group, which showed significant difference（P〈0. 05）. There was no significant difference in the TESS between the 2 groups（P〉0.05）. Conclusion Mirtazapine has diphasic action of anti-depression and-anxiety, its effect of anti-depression is equivalent to imipramine and that of anti-anxiety superior to imipramine, and has significant efficacy, higher safety and better compliance in depression associated with anxious symptoms.