文拉法辛联合米氮平治疗难治性抑郁症的疗效观察

Efficacy of Venlafaxine Combined with Mirtazapine in the Treatment of Refractory Depression

目的分析对于难治性抑郁症患者通过联合应用文拉法辛与米氮平的临床治疗价值。方法选取2018年1月至2019年12月徐州市东方人民医院收治的80例难治性抑郁症患者作为研究对象,并依据药物应用差异分为观察组和对照组,每组40例。对照组单纯采用文拉法辛治疗,观察组在此基础上加用米氮平治疗。比较2组患者的临床疗效,以及HAMD、SDSS、SF-36量表评分的测评结果和药物不良反应发生率。结果观察组患者治疗总有效率为97.50%,高于对照组85.00%(P<0.05);2组患者治疗前HAMD抑郁量表评分均较高,差异无统计学意义(P>0.05),而治疗1、3、6周后观察组HAMD抑郁量表评分降幅均优于对照组(P<0.05);2组患者治疗前SDSS、SF-36量表评分比较差异无统计学意义(P>0.05);治疗6周后观察组患者的SDSS量表评分降幅优于对照组,而SF-36量表评分上升幅度高于对照组(P<0.05);2组患者治疗期间恶心、头晕、心悸、便秘、失眠等药物不良反应发生率比较差异无统计学意义(P>0.05)。结论在难治性抑郁症患者的治疗中,通过联合应用文拉法辛与米氮平可显著提升患者的治疗效果,同时有利于改善患者的生活质量和社会功能缺陷,且联合用药安全性良好。

Objective To analyze the clinical value of venlafaxine and mirtazapine in patients with refractory depression.Methods Totally 80 patients with refractory depression admitted to Dongfang People's Hospital in Xuzhou City from January 2018 to December 2019 were selected as the research objects,and divided into observation group and control group according to differences in drug application,with 40 cases in each group.The control group was treated with venlafaxine alone,and the observation group was treated with mirtazapine on this basis.The clinical efficacy of the two groups of patients,as well as the evaluation results of the HAMD,SDSS and SF-36 scale scores and the incidence of adverse drug reactions were compared.Results The total effective rate of treatment in the observation group was 97.50%,which was higher than 85.00%in the control group(P<0.05);the scores of the HAMD depression scale before treatment in both groups were higher,and there was no statistically significant difference(P>0.05).However,after 1,3,and 6 weeks of treatment,the decrease in the HAMD depression scale scores of the observation group is now better than that of the control group(P<0.05);there is no statistically significant difference in the scores of the SDSS and SF-36 scales between the two groups of patients before treatment(P>0.05);after 6 weeks of treatment,the observation group’s SDSS scale score decreased better than the control group,while the SF-36 scale score increased more than the control group(P<0.05);nausea,There was no statistically significant difference in the incidence of adverse drug reactions such as dizziness,palpitations,constipation,and insomnia(P>0.05).Conclusion In the treatment of patients with refractory depression,the combined application of venlafaxine and mirtazapine can significantly improve the patient's treatment effect,and at the same time help to improve the patient's quality of life and social function defects,and the combination medication is safe.