《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (02): 176-177.

• 临床研究 • 上一篇    下一篇

米氮平与氟西汀治疗以失眠为主诉的老年抑郁症患者的对照研究

秦保健1;崔永华2;张翠荣1;李琳1   

  1. 1. 单县中心医院神经科，山东单县 274300;2. 北京安定医院精神科，北京市 100088
  • 收稿日期:2008-09-07 出版日期:2009-02-01 发布日期:2009-02-01

A Comparative Study of Mirtazapine and Fluoxetine in Treatment of Elderly Depressive Patients with Insomnia

QIN Bao-jian, CUI Yong-hua, ZHANG Cui-rong, et al   

  1. Shanxian Central Hospital, Shanxian 274300, Shandong, China
  • Received:2008-09-07 Published:2009-02-01 Online:2009-02-01

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被引次数

2

摘要： 目的 比较米氮平和氟西汀治疗以失眠为主诉的老年抑郁症患者的疗效和安全性。方法 92例以失眠为主诉的老年抑郁症患者随机分成两组，分别口服米氮平和氟西汀治疗，疗程6周。采用汉密尔顿抑郁量表（HAMD）减分率评定抗抑郁疗效，HAMD睡眠障碍因子和匹兹堡睡眠指数（PSQI）评定睡眠改善效果，副反应量表（TESS）评定用药的安全性。结果 米氮平组有效率90.9%（40/44），氟西汀组有效率84.1%（37/44），在治疗1、2、4周末，两组患者的HAMD评分差异均有非常显著性意义（P<0.001），而治疗6周末起差异无显著性意义（P>0.05）；两组患者的HAMD睡眠障碍因子和PSQI总分差异有显著性意义（P<0.05）。结论 米氮平治疗老年抑郁症总体疗效与氟西汀相当，但起效快，且能改善失眠症状，安全性高，依从性好，比氟西汀更适合老年抑郁症伴失眠患者的治疗。

关键词: 抑郁症, 失眠, 米氮平, 氟西汀

Abstract: Objective To compare the curative effects and safety of mirtazapine and fluoxetine in treatment of elderly depressive patients with insomnia.Methods 92 cases of elderly depressive patients with insomnia were randomly divided into two groups: the mirtazapine treatment group and the fluoxetine treatment group. The period of treatment was six weeks. The antidepressant effect was assessed with the drop rate of Hamilton Depression Scale (HAMD),the effect of improving sleep was assessed with HAMD sleep disturbance factor and the Pittsburgh Sleep Index (PSQI), and the administration of security was assessed with vice Treatment Emergent Symptom Scale (TESS).Results After treatment, the effective rate of the mirtazapine group was 90.9% (40/44), that of the fluoxetine group was 84.1% (37/44). In the end of 1st, 2nd, and 4th weeks after treatment, the difference between the two groups were significant (P<0.001). At the end of 6th week, the difference was not significant (P>0.05) in HAMD; the difference was significant in HAMD sleep disturbance factor and PSQI score (P<0.05).Conclusion The clinical effects of mirtazapine in treatment of depression are similar to that of fluoxetine, but mirtazapine takes effects fast, can improve the symptoms of insomnia, has higher safety and better compliance, and is more appropriate for the depressive elderly patients with insomnia than fluoxetine.

Key words: depression, insomnia, mirtazapine, fluoxetine