比较米氮平和氟西汀治疗原发性抑郁症患者的疗效及对其自主神经功能的影响

Comparative analysis of effects of Mirtazapine and Fluoxetine on autonomic nerve function of primary depression patients

目的:比较米氮平和氟西汀治疗原发性抑郁症患者的疗效及对其自主神经功能的影响。方法:将94例原发性抑郁症患者,根据治疗药物的不同分为A组和B组。A组患者(48例)采用米氮平治疗;B组患者(46例)采用氟西汀治疗。两组患者均于6周后,分别进行汉密顿抑郁量表17项(HAMD17)和皮肤交感反应(SSR)检测,并比较两组患者的HAMD17总分及各因子分、SSR潜伏期及波幅的差异。结果:治疗后,两组患者的HAMD17总分及各因子分均较治疗前明显降低,SSR潜伏期较治疗前缩短,波幅较治疗前升高,差异明显(P<0.05)。治疗后,B组患者较A组SSR潜伏期延长、波幅降低,HAMD17各因子分中焦虑和睡眠障碍评分明显高于A组(P<0.05);但治疗后,两组患者的HAMD17总分及其它各因子分差异无统计学意义(P>0.05)。相关分析得出HAMD17总分、各因子中焦虑、认识障碍、阻滞、睡眠障碍、绝望感分与SSR潜伏期呈正相关,与SSR波幅呈负相关,而日夜变化和体重与SSR潜伏期和波幅无相关性。结论:米氮平和氟西汀对原发性抑郁症患者总体疗效相当,但米氮平对其焦虑、睡眠障碍症状和其自主神经功能的改善作用优于氟西汀,且焦虑、认识障碍、阻滞、睡眠障碍、绝望感症状与自主神经功能存在一定的相关性。

Objective： To compare effects of Mirtazapine and Fluoxetine on autonomic nerve function of primary depression patients. Methods： 94 primary depression patients were divided into Group A（ n = 48,treated by Mirtazapine） and Group B（ n = 46,treated by Fluoxetine） according to the treatment drug. The treatment lasted for 6 weeks. Hamilton depression scale 17（ HAMD17）and sympathetic skin response（ SSR） were used to evaluated these patients,and the HAMD17 each factor and total scores,the SSR latencies and amplitudes of the two groups were compared. Results： The HAMD total each factor scores of the two groups after the treatment were significantly lower than those before the treatment,the SSR latencies were shorter,the SSR amplitudes were wider,and the differences were significant（ P0. 05）. The HAMD anxiety and sleep disorder scores of Group B after the treatment were significantly higher than those of Group A,the SSR latencies were longer,the SSR amplitudes were narrower（ P〈0.05）. But the HAMD total score and other factor scores had no statistical significant differences between Group A and Group B（ P〈0. 05）. The correlation analysis showed that HAMD17 total score and the factor scores of anxiety,cognitive disturbance,block,sleep disorder,and hopelessness were positively correlated with the SSR latency and negatively correlated with the SSR amplitude,but the factor scores of day and night change and weight were not correlated with the SSR latency and amplitude. Conclusions： The curative effects of Mirtazapine and Fluoxetine are similar,but the improvements of Mirtazapine in anxiety,sleep disorder and autonomic nerve function are better than Fluoxetine. Moreover,anxiety,cognitive disturbance,block,sleep disorder,and hopelessness symptoms has a certain correlations with the autonomic nerve function.