坦度螺酮联合米氮平治疗老年焦虑障碍的疗效观察

Efficacy of tandospirone combined with mirtazapine in treating senile anxiety disorder

目的探讨坦度螺酮联合米氮平治疗老年焦虑障碍的疗效,以期为临床治疗提供参考。方法选取2020年1月-2022年6月河南省开封市第五人民医院收治的80例老年焦虑障碍患者作为研究对象。按照随机数字表法将患者分为研究组和对照组,每组40例。对照组患者给予枸橼酸坦度螺酮口服治疗,研究组患者在对照组基础上加用米氮平。比较2组患者治疗前后(治疗后为治疗1个月时)汉密尔顿焦虑量表(HAMA)、焦虑自评量表(SAS)和匹茨堡睡眠质量指数量表(PSQI)评分。治疗1个月时,比较2组患者治疗效果。比较2组患者治疗前后(治疗后为治疗1个月时)5-羟色胺(5-HT)与皮质醇水平。比较2组患者干预期间不良反应发生情况。结果治疗前,2组患者HAMA、SAS评分比较,差异无统计学意义(P>0.05)。治疗后,2组患者HAMA、SAS评分均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者PSQI评分比较,差异无统计学意义(P>0.05)。治疗后,2组患者PSQI评分均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。研究组患者治疗总有效率为95.00%,高于对照组的72.50%,差异有统计学意义(P<0.05)。治疗前,2组患者5-HT及皮质醇水平比较,差异无统计学意义(P>0.05)。治疗后,2组患者5-HT水平高于治疗前,且研究组高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组患者皮质醇水平低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。研究组患者不良反应发生率为7.50%,低于对照组的30.00%,差异有统计学意义(P<0.05)。结论米氮平联合坦度螺酮治疗焦虑障碍效果显著,能改善患者焦虑症状及5-HT、皮质醇水平,提高患者睡眠质量,是一种安全有效的抗焦虑治疗方案,值得临床推广应用。

Objective This study aims to investigate the efficacy of tandospirone combined with mirtazapine in the treatment of anxiety disorders in the elderly to provide evidence for clinical treatment.Methods Eighty elderly patients with anxiety disorder admitted to the Fifth People's Hospital of Kaifeng from January 2020 to June 2022 were selected as the study participants.They were assigned to the study and control groups using a random number table,with 40 cases in each group.Patients in the control group received oral tandospirone citrate,while patients in the study group received mirtazapine on the basis of the control group.The Hamilton Anxiety Rating Scale(HAMA),Self-Rating Anxiety Scale(SAS),and Pittsburgh Sleep Quality Index(PSQI)scores were compared between the two groups before and after treatment(1 month after treatment).At 1 month of treatment,the therapeutic efficacy was compared between the 2 groups.5-hydroxytryptamine(5-HT)and cortisol levels were compared between the 2 groups before and after treatment(1 month after treatment).The incidence of adverse reactions during intervention was also compared between the groups.Results Before treatment,there was no significant difference in HAMA and SAS scores between the two groups(P>0.05).After treatment,the HAMA and SAS scores in the two groups were lower than those before treatment,and the study group was lower than the control group,with statistical significance(P<0.05).Before treatment,there was no significant difference in PSQI score between the two groups(P>0.05).After treatment,the PSQI scores of patients in the two groups were lower than those before treatment,and the study group was lower than the control group,with statistical significance(P<0.05).The overall response rate in the study group was 95.00%,which was significantly higher than that in the control group(72.50%;P<0.05).Before treatment,there was no significant difference in 5-HT and cortisol levels between the 2 groups(P>0.05).After treatment,5-HT levels in the 2 groups were significantly higher than those before treatment,with the study group significantly higher than the control group(P<0.05).After treatment,cortisol levels in the 2 groups were significantly decreased,and the study group was significantly lower than the control group(P<0.05).The incidence rate of adverse reactions in the study group was 7.50%,which was significantly lower than that in the control group(30.00%;P<0.05).Conclusion Mirtazapine in combination with tandospirone is effective in the treatment of anxiety disorder.It can improve anxiety symptoms,5-HT,and cortisol levels and increase the sleep quality of patients,which has high safety profiles and serve as an effective anxiolytic treatment.These advantages hold promise for a wider application of this procedure clinically.