米氮平治疗原发性高血压伴焦虑抑郁的疗效观察

Observation of the efficacy of mirtazapine in the treatment of essential hypertension complicated with anxiety and depression

目的分析米氮平治疗原发性高血压伴焦虑抑郁的临床疗效。方法 选取我院精神心理科2014年5月-2016年5月收治的患有原发性高血压患者共100例作为实验研究对象,将患者随机分为实验组和对照组,每组50例,对照组采用常规方法降压治疗并进行心理疏导,实验组在常规治疗基础上增加米氮平治疗,比较两组患者治疗效果、药物不良反应发生率及临床治疗有效率,临床治疗后采用HAMD及HAMA对两组患者进行评分。结果经治疗,实验组患者收缩压为（131.7±37.7）mmHg,对照组患者收缩压为（141.2±24.3）mmHg,实验组患者舒张压为（81.1±16.5）mmHg,对照组患者舒张压为（88.2±23.5）mmHg,两组差异有统计学意义（P〈0.05）;经治疗实验组总有效率94%,对照组总有效率74%,实验组药物不良反应发生率为8%,显著低于对照组的30%,差异均有统计学意义（P〈0.05）;实验组HAMD及HAMA总分降低相比于对照组明显,差异有统计学意义（P〈0.05）。结论 米氮平在原发性高血压治疗过程中,能明显改善患者焦虑抑郁症状,有效提高患者治疗依从性,具有临床推广价值。

Objective To analyze the clinical efficacy of mirtazapine in the treatment of essential hypertension complicated with anxiety and depression. Methods A total of 100 patients with essential hypertension who were enrolled in the department of spiritual psychology in our hospital from May 2014 to May 2016 were selected as research subjects. The patients were randomly divided into the experiment group and the control group, with 50 cases in each group. The control group was treated with conventional antihypertensive therapy and psychological counseling. The experimental group was further given mirtazapine on the basis of the conventional treatment. The therapeutic effect, incidence rate of adverse drug reactions and clinical treatment efficiency were compared between the two groups. HAMD and HAMA were used to evaluate the scores of the two groups after clinical treatment. Results After theI treatment, the systolic blood pressure in the experiment group was （131.7±37.7） mmHg, and the systolic blood pressure in the control group was （141.2±24.3） mmHg. The diastolic blood pressure in the experiment group was （81.1±16.5） mmHg. The diastolic blood pressure in the control group was （88.2±23.5） mmHg. The difference was statistically significant（P〈0.05）; after the treat- ment, the total effective rate was 94% in the control group, and the total effective rate was 74% in the Control group. The incidence of adverse drug reactions in the experiment group was 8%, which was significantly lower than that in the control group（30%）, and the differences were statistically significant（P〈0.05）. The reduction of HAMD and HAMA scores in the experimental group was significantly lower than that in the control group, and the differences were statistically significant （P〈0.05）. Conclusion Mirtazapine can significantly improve the clinical manifestation of anxiety and depression in the treatment of essential hypertension, and provide effective treatment compliance for the patient, which is of the value of clinical promotion.