米氮平联合草酸艾司西酞普兰片治疗精神分裂症后抑郁的效果

Effect of Mirtazapine Combined with Escitalopram Oxalate Tablets in the Treatment of Post-schizophrenic Depression

目的:探讨米氮平联合草酸艾司西酞普兰片对精神分裂症后抑郁的治疗效果。方法:选取我院2020年1月-2022年12月收治的80例精神分裂症后抑郁患者作为研究对象,分为对照组(n=30)、观察A组(n=25)与观察B组(n=25)。对照组患者应用10 mg/d艾司西酞普兰片治疗,观察A组应用15 mg/d米氮平联合10 mg/d艾司西酞普兰片治疗,观察B组应用30 mg/d米氮平联合10 mg/d艾司西酞普兰片治疗,对比三组治疗前后精神分裂症阴性与阳性症状量表(PANSS)评分、汉密尔顿抑郁量表(HAMD)评分和汉密尔顿焦虑量表(HAMA)评分、CT平扫脑结构检查结果以及不良反应发生率。结果:观察B组阴性症状PANSS评分、HAMD评分、HAMA评分低于观察A组和对照组(P<0.05);观察B组VI、TVW、HI评分低于观察A组和对照组,LVBI高于观察A组和对照组(P<0.05);三组均无急性骨髓抑制等严重不良反应发生,但观察B组不良反应总发生率高于观察A组和对照组(P<0.05)。结论:米氮平联合草酸艾司西酞普兰片治疗精神分裂症后抑郁疗效显著,但应用30 mg/d米氮平联合10 mg/d艾司西酞普兰片疗效更好,能够改善患者临床症状和焦虑、抑郁情况,并改善患者脑萎缩情况,但采取高剂量米氮平治疗会增加患者不良反应发生率,因此临床上剂量选择需结合患者实际情况进行治疗。

Objective:To investigate the therapeutic effect of mirtazapine combined with escitalopram oxalate tablets on postschizophrenic depression.Methods:A total of 80 patients with post-schizophrenic depression admitted to our hospital from January 2020 to December 2022 were selected as the research objects and divided into control group(n=30),observation group A(n=25)and observation group B(n=25).The patients in the control group were treated with 10 mg/d escitalopram tablets.The patients in the observation group A were treated with 15 mg/d mirtazapine combined with 10 mg/d escitalopram tablets.The patients in the observation group B were treated with 30 mg/d mirtazapine combined with 10 mg/d escitalopram tablets.The negative and positive symptom scale(PANSS)score,Hamilton depression scale(HAMD)score,Hamilton anxiety scale(HAMA),CT scan brain structure examination results and incidence of adverse reactions were compared among the three groups before and after treatment.Results:The PANSS score,HAMD score and HAMA score of negative symptoms in group B were lower than those in group A and control group(P<0.05).The VI,TVW and HI scores of observation group B were lower than those of observation group A and control group,and LVBI was higher than that of observation group A and control group(P<0.05).There were no serious adverse reactions such as acute myelosuppression in the three groups,but the total incidence of adverse reactions in the observation group B was higher than that in the observation group A and the control group(P<0.05).Conclusion:Mirtazapine combined with escitalopram oxalate tablets is effective in the treatment of post-schizophrenic depression,but the application of 30 mg/d mirtazapine combined with 10 mg/d escitalopram tablets is more effective.It can improve the clinical symptoms,anxiety and depression of patients,and improve the brain atrophy of patients.However,high-dose mirtazapine treatment will increase the incidence of adverse reactions.Therefore,clinical dose selection should be combined with the actual situation of patients.