米氮平联合草酸艾司西酞普兰对抑郁症患者睡眠质量及抑郁症的影响

Effects of mirtazapine combined with escitalopram oxalate on sleep quality and depression in patients with depression

目的:探讨米氮平及草酸艾司西酞普兰治疗抑郁症患者的临床效果。方法:选择2019年4月—2020年4月本院收治的64例抑郁症患者,依据随机数字表法分成两组各32例。对照组给予草酸艾司西酞普兰片口服治疗,初始剂量为10 mg/次,1次/d,根据患者个体反应,加大剂量为20 mg/次,1次/d,于晚上服用;观察组在此基础上加用米氮平片治疗,初始剂量为15 mg/次,1次/d,用药7 d后根据患者病情,加大剂量为30 mg/次,1次/d。两组需连续用药60 d。比较两组临床疗效、匹兹堡睡眠质量指数评分(PSQI)、汉密尔顿抑郁量表评分(HAMD)与不良反应。结果:观察组治疗总有效率为93.75%,高于对照组的75.00%,差异有统计学意义(P<0.05)。治疗前,两组入睡时间、睡眠时间、睡眠效率和睡眠障碍评分比较,差异无统计学意义(P>0.05);治疗后,两组入睡时间、睡眠时间、睡眠效率和睡眠障碍评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组HAMD评分比较,差异无统计学意义(P>0.05);治疗后,两组HAMD评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:米氮平联合草酸艾司西酞普兰治疗能够提高抑郁症患者睡眠质量,改善其抑郁状态,安全可靠。

Objective:To investigate the clinical effect of mirtazapine and esocitalopram oxalate in the treatment of depression.Methods:According to the random number table,a total of 64 patients with depression admitted to our hospital from April 2019 to April 2020 were selected and divided into two groups with 32 cases in each group.The control group was given esocitalopram oxalate orally with the initial dose of 10 mg/time,once a day.According to the patient's individual response,the increased dose was adjusted to 20 mg/time,once a day.The observation group was treated with mirtazapine tablets,and the initial dose was 15 mg/time,once a day.The dosage was increased to 30 mg/time,once a day after seven days,according to the patient's condition.The two groups were continuously treated for 60 days.Clinical efficacy,Pittsburgh sleep quality index score(PSQI)score,Hamilton scale of depression(HAMD)score,and adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was 87.50%,which was higher than the control group(67.50%),and the difference was statistically significant(P<0.05).Before treatment,there was no significant differences in time to fall asleep,sleeping time,sleep efficiency,and sleep disorder scores in both groups(P>0.05).After treatment,time to fall asleep,sleeping time,sleep efficiency,and sleep disorder scores in both groups were lower than before treatment,and the observation group was significantly lower than the control group(P<0.05).Before treatment,there was no significant difference in HAMD scores between the two groups(P>0.05).After treatment,the HAMD scores in both groups were lower than before treatment,and the observation group was statistically lower than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Mirtazapine combined with escitalopram oxalate can improve sleep quality and depressive state in patients with depression,which is safe and reliable.