米氮平结合认知行为疗法治疗惊恐障碍  

Study on Mirtazapine combining Cognitive-behavior therapy in the treatment of panic disorder

作　　者：彭冬英[1] 孔令军[1] 左小云[1] 朱秋根[1] 刘翔[1] 

机构地区：[1]江西省吉安市第三人民医院,吉安343000

出　　处：《江西医药》2007年第12期1106-1108,共3页Jiangxi Medical Journal

摘　　要：目的评价米氮平结合认知行为疗法治疗惊恐障碍的临床疗效、治疗依从性和复发、复燃情况。方法73例惊恐障碍患者随机分成两组,研究组口服米氮平30mg/晚,合并认知行为治疗;对照组单纯口服米氮平30mg/晚,疗程为12周。采用汉密尔顿焦虑量表(HAMA)评定疗效,分别于治疗前、治疗后第2,4,8,12周末各评定1次;1年后随访。结果治疗第12周末,研究组显效率91.9%(34/37),有效率100%(37/37);对照组显效率69.4%(25/36),有效率88.9%(32/36);两组间显效率、有效率比较分别为:χ2=5.932,P=0.015;χ2=4.349,P=0.037;治疗第4、8、12周末,两组间HAMA总分差异非常显著(P<0.001);1年后随访,研究组有4例擅自减药或停药,对照组有11例擅自减药或停药,两组间治疗依从性比较:χ2=4.357,P=0.037;两组间复发、复燃比较:研究组复发2例;对照组复发4例,复燃4例,χ2=4.365,P=0.037。结论米氮平合并认知行为疗法治疗惊恐障碍比单用米氮平治疗惊恐障碍的近期和远期疗效均更好,起效更快,依从性更好,复发率更低。Objective To evaluation the clinical curative effects,dependence on treatment,recurrence and relapse of mirtazapine combining cognitive behavior therapy （CBT） in the treatment of panic disorder. Methods 73 patients with panic disorder were randomly assigned to research group （n=37） and control group （n=36）.The patients of research group ate mirtazapine 30mg e,jnight with the CBT and those of control group were only given mirtazapine 30mg every night for 12 weeks.The curative effects were assessed with the Hamilton Anxiety Scale （HAMA）before treatment and at the end of the 2nd,4th,Sth and 12th week treatment,And follow-up 1a later.Results At the end of the 12th week, excellence and effective rates were 91.9% （34/37） and 100%（37/37） in the research group and 69.4%（25/36）and 88.9%（32/36） in the control group respectively.Compared the excellence and effective rates in the research group with those in the control grouP,X^2=5.932,P=0.015;X^2=4.349,P=0.037;at the end of the 4th,8th and 12th week,the difference of the total score of the HAMA of the two groups was very significantly （P〈0,001）,And follow up la later,4 and 11 patients presumed to reduce medicine or drug withdrawal.In the research group and control group respectively.By comparison between the two groups, dependence on treatment was X^2=4.357,P=0.037,recurrence and relapse were 2 recurrence in the research group and 4 recurrence and 4 relapse in the control group,X^2=4.365,P=0.037.Conclusion Mirtazapine combining the CBT is better than single mirtazapine in treating the patients with panic disorder, it has better curative effects both in early and later stages, better effective,better dependence on treatment and lower relapse rate.

关 键 词：认知行为疗法 惊恐障碍 米氮平 

分 类 号：R749.7[医药卫生—神经病学与精神病学]