米氮平治疗帕金森病抑郁的临床效果观察

Observation of the clinical effects of mirtazapine on treatment of depression in Parkinson’s disease

目的观察米氮平治疗帕金森病抑郁的有效性和安全性。方法选取2015-01~2018-01在武汉红桥脑科医院神经内科确诊为帕金森病抑郁的患者96例进行分析,按服药情况分为观察组和对照组,每组48例。观察组给予米氮平治疗,对照组给予舍曲林治疗,疗程均为12周,记录患者治疗前后汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分、日常生活能力量表(Activity of Daily Living Scale,ADL)评分、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)评分及治疗期间的不良反应发生情况。结果治疗前,两组年龄、性别、帕金森病程、帕金森抑郁病程、HAMD、ADL、PSQI评分差异均无统计学意义( P >0.05)。治疗12周后,两组HAMD、PSQI评分比治疗前均降低,ADL评分均升高;但观察组HAMD、PSQI评分低于对照组,而ADL评分高于对照组,差异均有统计学意义( P<0.05)。观察组胃肠道反应率低于对照组,差异有统计学意义( P<0.05)。结论帕金森病抑郁选择药物治疗时,米氮平有较好的抗抑郁作用,且不良反应较舍曲林少,可作为帕金森病抑郁治疗的选择之一。

Objective To observe the efficacy and safety of mirtazapine in treatment of depression in Parkinson′s disease. Methods A retrospective study was performed on 96 Parkinson′s disease patients with depression in the Department of Neurology, Wuhan Hongqiao Brain Hospital from January 2015 to January 2018. They were divided into control group and observation group according to different medications, with 48 cases in each group. The observation group was treated with mirtazapine and the control group was treated with sertraline. The treatments lasted foR12 weeks in the two groups. The Hamilton Depression Scale (HAMD)score, Activity of Daily Living Scale(ADL) score, Pittsburgh Sleep Quality Index(PSQI) score, and adverse events during treatment period were recorded in both groups. Results Before treatment, there were no significant differences in age, sex, Parkinson′s disease course, depression course and the scores of HAMD、ADL and PSQI between the two groups( P>0.05). AfteR12 weeks of treatment, the HAMD and PSQI scores of both groups decreased, and the ADL scores increased. The HAMD and PSQI scores in the observation group were loweRthan those in the control group, while the ADL scores in the observation group were higheRthan those in the control group( P <0.05). The observation group had less adverse reactions to gastrointestinal tract than the control group, and the difference was statistically significant( P<0.05). Conclusion Mirtazapine has a betteRantidepressant effect than sertraline on the Parkinson′s disease patients with depression, and the adverse reactions of mirtazapine is less than that of sertraline. Mirtazapine can be used as one of the choices foRtreatment of depression in Parkinson ′s disease.