米氮平联合喹硫平治疗难治性抑郁症对照研究  

A control study of mirtazapine combined with quetiapine in the treatment of treatment-resistant depression

作　　者：赵峥[1] 程哲[1] 程传宝[1] 

机构地区：[1]河南省精神病医院精神科,新乡市453002

出　　处：《职业与健康》2013年第1期126-128,共3页Occupation and Health

摘　　要：目的探讨米氮平联合喹硫平治疗难治性抑郁症的临床疗效与安全性。方法将76例难治性抑郁症患者随机分为研究组38例,对照组38例,2组均口服米氮平治疗,研究组在此基础上联合喹硫平治疗,观察8周。于治疗前及治疗第2、4、6、8周末采用汉密顿抑郁量表、汉密顿焦虑量表、临床总体印象量表疾病严重程度分量表评定临床疗效,副反应量表评定不良反应。结果治疗后2组汉密顿抑郁量表、汉密顿焦虑量表及临床总体印象量表疾病严重程度分量表评分均较治疗前显著下降(P<0.01),治疗4、6、8周末研究组均较对照组下降更显著(P<0.05或0.01);治疗8周末研究组显效率为73.7%,总有效率86.8%,对照组分别为42.1%、60.5%,研究组显效率、总有效率均显著高于对照组(χ2=7.77、6.78,P<0.01)。研究组不良反应发生率为31.6%,对照组为26.3%,2组不良反应程度均较轻,同期副反应量表评分差异无统计学意义(P>0.05)。结论喹硫平对治疗难治性抑郁症具有增效作用;米氮平联合喹硫平治疗难治性抑郁症疗效显著,起效快,安全性高,依从性好,显著优于单用米氮平治疗。[Objective]To explore the clinical efficacy and safety of mirtazapine combined with quetiapine in the treatment of treatment-resistant depression（TRD）.[Methods]76 TRD patients were randomly divided into the research group and the control group,38 cases in each group.Both two groups received orally mirtazapine,and the research group was given additional quetiapine,for 8 weeks.The clinical efficacy was assessed with the Hamilton Depression Scale（HAMD）,Hamilton Anxiety Scale（HAMA） and Clinical Global Impression（CGI-SI） before treatment and at the end of the 2nd,4th,6th and 8th week of treatment,and adverse reactions were evaluated with Treatment Emergent Symptom Scale（TESS）.[Results]After treatment,HAMD scores,HAMA scores and CGI-SI scores of both groups decreased significantly as compared with those before treatment（P0.01）,so did in the research group than in the control group at the end of the 2nd,4th,6th and 8th week（P0.05 or P0.01）.At the end of the 8th week,the obvious effect rate and total effective rate in the research group（73.7% and 86.8%） were significantly higher than those in the control group（42.1% and 60.5%） significantly（χ2=7.77 and 6.78,P0.01）.The incidence rate of adverse reactions in the research group and the control group was 31.6% and 26.3% respectively,the adverse reactions of both groups were mild,and there were no significant differences in the TESS scores in the corresponding period（P0.05）.[Conclusion]Quetiapine has a synergistic action in the treatment of TRD.Mirtazapine combined with quetiapine has more obvious efficacy,faster action,higher safety and better compliance as compared with single mirtazapine in the treatment of TRD.

关 键 词：难治性抑郁症 米氮平 喹硫平 汉密顿抑郁量表 汉密顿焦虑量表 临床总体印象量表 副反应量表 

分 类 号：R395.4[哲学宗教—心理学]