米氮平与帕罗西汀治疗首发伴焦虑症状老年抑郁症的对照研究

Control study of Mirtazapine VS Paroxetine in treating first-episode geriatric depression with anxiety symptoms

目的:评价米氮平对首发伴焦虑症状老年抑郁症的疗效、安全性及其对生活质量的影响。方法:将86例首发伴焦虑症状老年抑郁症患者随机分为A组(米氮平组)和B组(帕罗西汀组),疗程8周。用汉密尔顿抑郁量表(HAMD17)和不良反应量表(TESS)在治疗前和治疗第1、2、4、6、8周末进行疗效与不良反应评定,用生活质量综合评定问卷(GQOL-74)在治疗前和治疗第8周末进行生活质量评定。结果:A组第1周末HAMD17评分低于B组(t=4.93,P<0.01);8周末,两组GQOL-74评分,除物质生活维度外,其它三个维度评分A组明显优于B组(t=2.5,3.62,2.56;P<0.05 or P<0.01);两组不良反应无统计学意义(x2=0.847,P>0.05)。结论:米氮平具有起效快,能显著改善患者的睡眠、焦虑及躯体不适症状,提高患者的生活质量,有利于患者回归社会,不良反应少而轻,可作为老年抑郁症的首选药物。

Objective： To evaluate the efficacy, safety and influence of Mirtazapine on quality of life of first - episode geriatric depression with anxiety symptoms. Methods：86 patients with first - episode geriatric depression were randomly assigned to group A （Mirtazapine group） and group B （Paroxetine group）, The course of treatment was 8 weeks. Hamilton Depression rating scale（ HAMD17） ,Treatment Emergent symptom scale （TESS） were used to assess the efficacy and side effects respectively before treatment and after treatment 1,2,4,6,8 weekends. General quality of life inventory （GQOL -74） was analyzed at baseline and the end of the study. Results： The score of HAMD17 of group A was lower than it of group B （t =4.93,P 〈0.01 ） ;After 8 weeks treatment , the scores of other three dimensions of GQOL - 74 in group A improved obviously than those in group B except the material life dimensions （t =2.5,3.62,2.56; P 〈 0.05 or P 〈 0.01 ）; There was no significant difference in adverse reactions between both groups （x2 = 0.15, P 〉 0.05 ）. Conclusions： Mirtazapine with a rapid onset can significantly improve the patient＇s sleep, anxiety and somatic symp- toms , and improve quality of life of patients, which is help for patents to return to society, and can be used as first medicine choice for geriatric depression because of its few and mild adverse reactions.