艾司西酞普兰联合米氮平治疗难治性抑郁症临床观察

Clinical Observation of Escitalopram Joint Mirtazapine in Treatment-resistant Depression

目的:探讨分析艾司西酞普兰联合米氮平治疗难治性抑郁症效果。方法:选择2013年6月-2015年5月门诊及住院的114例难治性抑郁症患者,将其随机分为观察组(57例)和对照组(57例),观察组患者应用艾司西酞普兰联合米氮平,对照组患者单纯应用艾司西酞普兰,对比两组患者治疗前及治疗后2、4、6、8周的HAMD(汉密顿抑郁量表)以评估治疗效果,采用副反应量表(TESS)评估药物不良反应。结果:观察组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。两组患者在治疗2周后,其HAMD均有明显下降,和治疗前比较,差异均有统计学意义(P<0.05)。观察组治疗4、6、8周后的HAMD评分低于对照组,差异均有统计学意义(P<0.05)。观察组出现15例副反应,发生率为26.32%,分别为头痛5例,嗜睡2例,食欲增加1例,口干2例,便秘5例,对照组出现14例副反应,发生率为24.56%,分别为头痛4例,嗜睡1例,食欲增加2例,口干3例,便秘4例,观察组副反应发生率与对照组比较差异无统计学意义(P>0.05)。结论:艾司西酞普兰联合米氮平治疗难治性抑郁症效果优于艾司西酞普兰单用,两药联用药物副反应无明显增加。

Objective：To investigate the effect of Escitalopram combined with Mirtazapine in the treatment of refractory depression.Method：114 cases of refractory depression patients in outpatient and inpatient of our hospital from June 2013 to May 2015 were selected and randomly divided into observation group（57 cases） and control group（57 cases）.The observation group was treated with Escitalopram joint Mirtazapine,the control group was given a simple application of Escitalopram.HAMD（Hamilton depression scale） was compared between the two groups of patients before treatment and two weeks,four weeks,six weeks,eight weeks after treatment in order to evaluate the treatment effects.Treatment emergent symptom scale（TESS） was used to assess the adverse drug reactions.Result：The total effective rate of the observation group was significantly higher than that of the control group,the difference was statistically significant（P0.05）.Compared with before treatment,the HAMD of the two groups were significantly reduced in the first two weeks after treatment,the difference was statistically significant（P0.05）.After 4 weeks,6 weeks and 8 weeks treatment,the HAMD scores of the observation group were lower than those of the control group,the differences were statistically significant（P0.05）.The observation group had 15 cases of adverse reactions,the incidence rate was 26.32%,5 cases had headache,2 cases had somnolence,1 case had increased appetite,2 cases had dry mouth,5 patients had constipation.The control group had 14 cases of adverse reactions,the incidence rate was 24.56%,4 cases had headache,1 case had lethargy,2 cases had increased appetite,3 cases had dry mouth,4 cases had constipation.The differences in the incidence of side effects between the two groups were not statistically significant（P0.05）.Conclusion：Escitalopram joint Mirtazapine in the treatment of refractory depression is better than Escitalopram alone.The side effects associated with the combination use of the two drugs don＇t increase significantly.