瑞美隆与多虑平治疗脑卒中后抑郁的疗效与安全性的比较研究

Comparative Study of Efficacy and Safety of Mirtozapine and Doxepine in Treatment of Patients with Post-stroke Depression

目的比较瑞美隆(米氮平)与多虑平治疗脑卒中后抑郁的疗效和安全性。方法140例伴有抑郁的急性脑卒中患者被分为瑞美隆、多虑平和对照组,分别在治疗前及治疗后第2、4、8周行HAMD、CSS、Barthel指数评分,并观察不良反应。结果瑞美隆和多虑平组在治疗后评分HAMD、CSS显著下降(P<0.05);Barthel指数治疗后显著增加(P<0.05);对照组则无显著变化(P>0.05);两研究组之间比较变化无显著性(P>0.05)。多虑平组口干、便秘、尿潴留等副作用显著高于瑞美隆组(P<0.05)。结论瑞美隆和多虑平都能改善脑卒中后抑郁,但瑞美隆不良反应少,提示瑞美隆更适用于脑卒中后抑郁患者的治疗。

Objective To compare and study the efficacy and safety of mirtazapine and doxepine in treatment of patients with post- stroke depression. Methods Totally 140 early post- stroke depressive patients were randomly divided into 3 groups, including mirtazapine group, doxepine group, and control group （without anti depressive drugs）. Evaluations were conducted before the treatment and 2, 4 and 8 weeks after treatment by using the Hamilton Depressive Scale （HAMD）, Chinese stroke scale （OSS）, and Barthel index （BI）. Side reactions of above drugs were observed. Results HAMD and CSS scores reduced significantly after the treatment （P 〈 0.0.5）, while BI increased significantly in mirtazapine group and doxepine group （P〈 0.05）; there was no significant difference in the two treatment groups. The significant changes of these parameters in control group did not happen. As compared with mirtazapine group, doxepine group showed more side effects such as thirsty, constipation, and retention of urine, etc. Conclusions Both of mirtazapine and doxepine can alleviate post stroke depression but mirtazapiae has less side effects. These suggest that mirtazapine is more fit for treating patients with post- stroke depression.