米氮平合并奥氮平治疗老年抑郁障碍的疗效及安全性研究

Research of curative effect and safety by mirtazapine combined with olanzapine in the treatment of senile depressive disorder

目的评价米氮平合并奥氮平治疗老年抑郁障碍的临床疗效及其安全性。方法 43例老年抑郁障碍患者,随机分为实验组(采用奥氮平合并米氮平治疗,21例)和对照组(采用米氮平单药治疗,22例),分别在治疗后1、2、4、6、8周采用17项汉密尔顿抑郁量表(HAMD-17)及副反应量表(TESS)评估两组患者临床疗效及不良反应。结果治疗后4、6、8周,两组HAMD-17评分较治疗前均显著降低,差异具有统计学意义(P<0.05);治疗后6、8周,实验组HAMD-17评分较对照组显著降低,差异具有统计学意义(P<0.05)。治疗8周后,实验组患者12例体重增加,对照组5例体重增加,实验组8例嗜睡,对照组2例嗜睡,两组比较差异具有统计学意义(P<0.05)。实验组与对照组其他不良反应如恶心(3例VS4例)、口干(5例VS 5例)、便秘(4例VS 3例)发生情况比较差异无统计学意义(P>0.05)。结论米氮平合并奥氮平治疗老年抑郁障碍起效快,临床疗效好,但可明显增加患者体重,增加嗜睡患者。

Objective To evaluate clinical effect and safety by mirtazapine combined with olanzapine in the treatment of senile depressive disorder. Methods A total of 43 senile depressive disorder patients were randomly divided into experimental group（received mirtazapine combined with olanzapine for treatment, 21 cases）and control group（received mirtazapine for treatment alone, 22 cases）. Evaluation of clinical effects and adverse reactions in the two groups were made by 17-item Hamilton depression scale（HAMD-17）and treatment emergent symptom scale（TESS） in 1, 2, 4, 6, 8 weeks after treatment. Results In 4, 6, 8 weeks after treatment, both groups had obviously lower HAMD-17 scores than those before treatment, and their difference had statistical significance（P〈0.05）. In 6 and 8 weeks after treatment, the experimental group had much lower HAMD-17 scores than the control group, and the difference had statistical significance（P〈0.05）. In 8 weeks after treatment, there were 12 cases with weight gain in the experimental group and 5 cases in the control group, and there were 8 cases with somnolence in the experimental group and 2 cases in the control group. The difference between the two groups had statistical significance（P〈0.05）. There was no statistically significant difference of other adverse reactions of nausea（3 cases VS 4 cases）, xerostomia（5 cases VS 5 cases）and constipation（4 cases VS 3 cases）between the experimental group and the control group（P〈0.05）. Conclusion Combination of mirtazapine and olanzapine in treating senile depressive disorder shows quick onset effect and excellent clinical effect. This method can remarkably increase weight and reduce somnolence in patients.