米氮平治疗老年惊恐障碍疗效观察  

To compare the effection of mirtazapine in treating elderly phobia disorder

作　　者：钟天平[1] 冯梅珍[1] 黎宏[1] 廖利江[1] 谢玲银[1] 

机构地区：[1]广东省人民医院省精神卫生研究所,广东广州510120

出　　处：《中国民康医学》2007年第11期447-448,共2页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨米氮平治疗老年惊恐障碍的疗效。方法:将符合入组标准老年惊恐障碍患者,随机分成米氮平治疗组30例及帕罗西汀对照组24例,两组年龄、病程、HAMA评分、HAMD评分、CGI-S无显著性差异。在原治疗躯体疾病药物不变的情况下,米氮平治疗组服用米氮平15～45 mg/日,帕罗西汀对照组服用帕罗西汀10～30 mg/日。结果:54例患者惊恐发作时临床表现:心血管症状(心慌、胸闷、胸痛、心前区压迫感、头晕、昏厥等)37例次(68.5%),呼吸系统症状(呼吸困难、呼吸急促、窒息感等)21例次(38.9%),消化系统症状(恶心、腹胀、腹泻、饥饿感、食欲不振等)11例次(20.4%),植物神经系统症状(手抖、面部潮红、出汗、四肢麻木、怕冷等)42例次(77.8%);运动系症状(坐立不安、来回走动等)41例次(75.9%),精神症状(阵发性濒死感、害怕失控、发疯、紧张恐惧等)34例次(63.0%);睡眠障碍(入睡困难、觉醒时间延长、多梦、早醒等)48例次(88.9%)。治疗组和帕罗西汀对照组在治疗的第2周末、第4周末和第8周末Hamilton焦虑量表评分和Hamilton抑郁量表评分较入组前明显减少,差异有显著性。两组之间在各个治疗时段比较差异无显著性。治疗组和对照组在治疗的第4周末和第8周末临床疗效总评量表-病情严重程度评分较入组前明显减少,差异有显著性。两组之间在各个治疗时段比较差异无显著性。结论:米氮平治疗老年惊恐障碍疗效肯定,与帕罗西汀疗效相当。Objective：To explore the effection of mirtazapine in treating elderly phobia disorder. Methods：Elderly patients with phobia disorder were randomly divided into mirtazapine group （n = 30） and paroxetine group （n = 24）. Two groups shared similar age, disease duration, HAMA score, HAMD score, and CGI -S score. The mirtazapine was permitted from 15 -45mg/day; the paroxetine was permitted from 10 - 30mg/day, whilst all of patients could follow their original regiment in treating their physiological disease. Results： the clinical symptoms of 54 patients in their phobia outbreak： 37 （68.5%） cardio logical symptom （heart - throb, chest pressure, chest pain, heart pressure, head swirl, and syncope） ; 21 （38.9%） respiration symptom （dyspnoea, hurry breath, and choke） ; 11 （20.4%） digestive symptom （nausea, abdomen distend, diarrhea, hunger feeling, and poor appetite）, 42 （77. 8% ） vegetable nerve symptom （hand trembling, blood flush in face, sweating, limb numbness, and cold） ;41 （75.9%） motive symptom （ fidget and go around） ; 34 （63.0%） psychiatry symptom （ intermittent feeling of death, out of control, crazy, nervous） ; And 48 （88.9%） sleep disorder （difficulty in initiating sleep, lengthening waking time, more dream, early waking）. In the second, fourth, and eighth week, both groups expressed lower score of HAMA and HAMD than baseline, which reached significant difference. On the other hand, in the fourth and eighth week, both groups expressed lower CGI score than baseline, which reached significant difference. Both groups shared similar score in all treatment points. Conclusions： this study confirmed the effectiveness of mirtazapine in treating elderly phobia disorder, which was similar to that of paroxetine.

关 键 词：惊恐障碍 老年患者 米氮平 帕罗西汀 

分 类 号：R749.7[医药卫生—神经病学与精神病学]