米氮平对体质量减轻型功能性消化不良伴抑郁患者的临床疗效

Effect of mirtazapine in depressive functional dyspepsia patients with weight loss

目的探讨米氮平对体质量减轻型功能性消化不良（functional dyspepsia with weightloss，FD—WL）伴抑郁患者的临床疗效。方法采用前瞻、随机、对照临床研究，72例消化内科连续就诊的FD—wL伴抑郁患者随机分成常规治疗组、米氮平组、帕罗西汀组，治疗8周，分别于用药前、用药2周、4周、6周、8周后检测尼平消化不良指数症状量表（NDI一症状量表）、17项汉密尔顿抑郁量表（HAMD-17）、体质量等指标。结果（1）从治疗第2周开始，米氮平组的NDI一症状量表评分和HAMD．17项评分显著性低于其他两组（均P〈0．05）；治疗4周后、治疗6周后和治疗8周后，米氮平组『（13．34±1．52）分，（11．65±1．56）分，（10．15±1．36）分]和帕罗西汀组[（13．65±1．81）分，（11．34±1．21）分，（9．58±1．41）分]的HAMD-17评分均显著低于常规治疗组[（18．15±1．61）分，（17．20±2．14）分，（15．30±1．56）分]（均P〈O．05），但米氮平组和帕罗西汀组比较差异无统计学意义（P〉0．05）。（2）治疗6周后和治疗8周后，米氮平组[（53．17±6．46）kg，（53．55-6．52）k]体质量显著性高于帕罗西汀组[（49．47±5．72）kg，（49．57±5．81）kg]和常规治疗组[（48．69±5．60）k，（48．68±5．65）kg]（均P〈0．05），其中米氮平组的体质量增加量（3．34±1．82）kg。结论米氮平不仅能显著改善FD—WL伴抑郁患者的消化不良症状和抑郁情绪，还可显著增加体质量。

Objective To discuss the effect of mirtazapine in depressive functional dyspepsia pa- tients with weight loss （FD-WL）. Methods As a randomized and controlled trial, seventy-two FD patients with weight loss and depression were randomly divided into mirtazapine group（ n= 24） , paroxetine group（ n= 23 ） and conventional group（ n= 25 ） , and all patients were treated for 8 weeks. The Nepean Dyspepsia Index （NDI） - symptom checklist, the Hamilton Rating Scale of Depression （ HAMD ） , body weight were assessed before the treatment and after 2,4,6,8 week. Results （ 1 ） After 2-week treatment, the scores of NDI- symptom checklist and HAMD in mirtazapine group were significantly lower than that in paroxetine group and conventional group. After 4-week, 6-week and 8-week treatment, the score of HAMD in mirtazapine group （ （ 13.34±1.52）, （ 11.65±1.56）, （ 10.15± 1.36） ） and paroxetine group（ （ 13.65± 1.81 ）, （ 11.34± 1.21 ）, （ 9.58± 1.41 ） ） was significantly lower than that in conventional group （ （ 18.15 ± 1.61 ）, （ 17.20± 2.14）, （ 15.30± 1.56） ） （all P〈0.05 ）.But there was no statistically difference between mi,＇tazapine group and parox- etine group （P〉0.05）. （2） After 6-week and 8-week treatment ,the body weight in mirtazapine group（（53.17±6.46） kg, （53.55±6.52） kg） was significantly higher compared with that in paroxetine group（（49.47±5.72） kg, （49.57±5.81） kg） and conventional group（（48.69±5.60） kg, （48.68±5.65）kg）（all P〈0.05）. After 8-week treatment,patients in mirtazapine group experienced a weight gain of（3.34±1.82）kg. Conclusion Mirtazapine not only can significantly improve dys-pepsia symptoms and depressive scoring,but also can increase body weight.