摘要
目的探讨艾司西酞普兰联合米氮平治疗未取得抑郁症状早期改善患者的疗效和安全性。方法第一阶段:将200例符合ICD-10抑郁症诊断标准的患者接受艾司西酞普兰治疗2周;第二阶段:将所有未达早期改善的患者(2周内汉密尔顿抑郁量表评分减分率<20%)随机分为2组,其中联合用药组予艾司西酞普兰联合米氮平治疗(n=38),单用药组继续予艾司西酞普兰片治疗(n=32),治疗持续6周。治疗每周末用汉密尔顿抑郁量表(HAMD-17)评定患者抑郁症状及疗效,同时用TESS和实验室检查评估治疗安全性。结果第二阶段治疗1、2、4、6周末联合用药组HAMD减分率均显著大于单用药组。研究终点联合用药组治愈22例(57.9%),有效30例(78.9%),无效8例(21.1%);单用药组治愈9例(28.1%),有效18例(56.3%),无效14例(43.7%)。联合用药组疗效优于单用药组(P<0.05)。结论联合米氮平可以改善经艾司西酞普兰治疗未取得早期改善抑郁症患者的8周疗效,安全性良好,不影响患者的治疗依从性。
AIM To explore the efficacy and safety of escitalopram combined with mirtazapine in treatment of depression patients who did not achieve early improvement. METHODS In the first stage 200 patients who met ICD-10 criteria for depression were treated by escitalopram for 2 weeks, and in the second stage the patients who did not achieve early improvement were divided into research group（treated by escitalopram combined with mirtazapine）（ n = 38 ） and control group（treated by escitalopram only）（ n = 32） randomly. The trial lasted 6 weeks. The early improvement was de- fined as reduction rate of Hamilton Depression Scale 〉I 20 % in 2 weeks. The depression status and efficacy were evaluat- ed with HAMD-17（Hamilton Depression Scale-17） and the safety was evaluated by TESS and laboratory examination. RESULTS The reduction rate of HAMD in the research group was more obvious than that in control group by the end of 1 st, 2th, 4th, 6th week（P 〈 0.05） respectively in the second stage. The remission rate of both groups was 57.9% vs 28.1%, and response rate was 78.9 % vs 56.3 % by the end of this research which had significant difference （ t = 4. 771, P = 0. 000）. The compliance of both groups had no significant difference（ P 〉 0.05）. CONCLUSION Escitalopram combined with mirtazapine is more effective and can improve the efficacy in the treatment of depression patients who can not achieve early improvement, and will not affect the compliance.
出处
《中国临床药学杂志》
CAS
2016年第2期82-85,共4页
Chinese Journal of Clinical Pharmacy
基金
湖州市科技局项目(编号2014GYB06)
