米氮平与阿米替林治疗抑郁症对照研究

A control study of mirtazapine vs. amitriptyline in the treatment of depression

目的 探讨米氮平治疗抑郁症的临床疗效及安全性.方法 将72例抑郁症患者随机分为两组,每组36例,研究组口服米氮平治疗,对照组口服阿米替林治疗.观察6周.于治疗前及治疗1周、2周、4周、6周末采用汉密顿抑郁量表、临床总体印象量表评定临床疗效,副反应量表评定不良反应.结果治疗后两组汉密顿抑郁量表、临床总体印象量表评分均较治疗前显著下降（P＜0.01）.治疗第1周、2周末研究组汉密顿抑郁量表评分较对照组下降更显著（P＜0.01）,有效率显著高于对照组（P＜0.05）;治疗4周、6周末两组差异无显著性（P＞0.05）.研究组不良反应发生率为44.4%,对照组为69.4%,研究组不良反应发生率显著低于对照组（P＜0.05）,治疗各时段副反应量表评分均显著低于对照组（P＜0.01）.结论 米氮平治疗抑郁症疗效显著,起效快,安全性更高,依从性更好,显著优于阿米替林.

Objective To explore the clinical efficacy and safety of mirtazapine in the treatment of depression. Methods Seventy-two depression patients were randomly assigned to two groups of 36 ones each, research group took orally mirtazapine and control group did amitriptyline for 6 weeks. Clinical efficacies were assessed with the Hamilton Depression Scale （HAMD） and Clinical Global Impression （CGI） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the 1^st , 2^na , 4^th and 6^th week. Results After treatment the HAMD and CGI scores of both groups lowered more significantly compared pretreatment （P〈0.01）. At the end of the 1^st and 2^na week, the HAMD score lowered more significantly （P〈0.01） and effective rate was significantly higher （P〈0.05） in the research than in the control group; At the end of the 4th and 6th week, there were no significant differences between two groups （P〈0.05）; incidences of adverse reactions （44.4% vs. 69.4%, P〈0.05） and the TESS scores of all periods （P〈0.01） were significantly lower in the research than in the control group. Conclusion Mirtazapine has a significant curative effect, higher safety and better compliance, and takes effect more rapidly in the treatment of depression compared with amitriptyline.