米氮平与文拉法辛治疗适应障碍的疗效观察

The clinical comparison study on treating adjustment disorder with mirtazapine and venlafaxine

目的观察米氮平在治疗适应障碍中的疗效及副反应。方法根据治疗方法将符合CCMD-3适应障碍诊断标准的74例适应障碍患者分为米氮平组和文拉法辛组各37例,两组均用药观察6周,采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和副反应量表(TESS)进行疗效和副反应评定。结果米氮平组显效率为75.00%,有效率为91.67%,文拉法辛组显效率为37.14%,有效率为57.14%,两组显效率和有效率比较,差异均具有统计学意义(P<0.01)。两组治疗后HAMD、HAMA评分均逐渐减低,治疗2周后两组间HAMA评分比较,差异有统计学意义(P<0.05),治疗4、6周后两组间HAMD、HAMA评分比较,差异具有统计学意义(P<0.01)。两组不良反应比较,差异具有统计学意义(P<0.01)。结论米氮平治疗适应障碍起效快,疗效高,安全性好。

Objective To evaluate the efficacy and adverse reaction of mirtazapine in the treatment of adjustmentdisorders. Methods 74 patients with adjustment disorders were randomly assigned into two groups,The treatmentgroup received mirtazapine tabletes and the control group received venlafaxine capsules.The treatment course covered6 weeks.The clinical effect was assessed by Hamilton depression scale（HAMD）,Hamilton anxiety scale（HAMA） andthe adverse reaction was assessed by treatment emergent symptom scale（TESS）. Results The patients treated withmertazapine showed an excellently effective rate 75.00% and effective rate of 91.67%,as compared with an excellentlyeffective rate of 37.14% and an effective rate of 57.14% in the patients treated with venlafaxine.The differences beinghighly significant （P 〈 0.01）.During the treatment,the scores of HAMD and HAMA were all gradually decreasedin both groups,and the differences of HAMA scores between the two groups after treatment of 2 weeks weresignificent （P〈 0.05）.By the end of 4 weeks and 6 weeks after treatment,the differences of HAMD and HAMA scoresbetween the two groups were highly significent（P 〈 0.01）,and the incidence of adverse reactions between the twogroups was also highly significant（P 〈 0.01）. Conclusion Mirtazapine takes effect faster and has significant curativeeffects,higher safety.