度洛西汀合并小剂量米氮平与单用度洛西汀治疗老年期难治性抑郁症的对比研究

Comparison of effect between duloxetine combined with small-dose of mirtazapine and duloxetine in treatment of refractory depression in elder patients

目的：比较度洛西汀合并小剂量米氮平与单用度洛西汀治疗老年期难治性抑郁症的临床疗效和安全性。方法选取2011年3月～2014年3月期间收治的100例难治性抑郁患者作为研究对象，将100例患者随机分为2组，其中观察组（度洛西汀＋米氮平）50例，对照组（度洛西汀）50例。比较2组患者的HAMD、HAMA和CGI-SI量表评分，比较两组患者的TESS评分和不良反应发生率，对患者的米氮平血药浓度和HAMD减分率进行回归分析。结果经过治疗后，观察组治疗总有效率为92.00％，对照组为76.00％，2者差异具有统计学意义（P＜0.05）。经过治疗后，2组患者的HAMD、HAMA和CGI-SI评分较治疗前均明显改善（P＜0.05）；观察组和对照组2、4、8周后的HAMD、HAMA和CGI-SI评分差异有统计学意义（P＜0.05）。2组患者的TESS评分和不良反应发生率差异无统计学意义。结论度洛西汀联合小剂量米氮平治疗老年难治性抑郁症的疗效优于单用度洛西汀，联合用药不会明显增加不良反应的发生率。

Objective To compare effect and security between duloxetine combined with small-dose of mirtazapine and duloxetine alone in treatment of refractory depression in elder patients.Methods A total of 100 cases elder refractory depression patients were randamly divided into study group （duloxetine＋mirtazapine, 50 cases） and control group（duloxetine, 50 cases）.Compared HAMD,HAMA and CGI-SI between two groups, as well as the side reactions and TESS.Regression analysed mirtazapine blood concentration and HAMD subtraction rate.Results The effective rate of study group was 92.00%, while in control group was 76.00%, the difference was statistically significant（P〈0.05）.After treatment, the HAMD, HAMA and CGI-SI of each group significantly increased, and the difference of HAMD, HAMA and CGI-SI at 2w, 4w and 8w between two groups were statistically significant（P〈0.05）.The TESS and side reaction of two groups had no statistical difference.Conclusion Effect of duloxetine combined with small-dose of mirtazapine in treatment of refractory depression is better than duloxetine alone use, without significant side reaction.