米氮平治疗躯体形式障碍41例临床观察  

Clinical observation of mirtazapine in the treatment of somatoform disorders

作　　者：韩学青[1] 牛雅娟[2] 张燕波[1] 

机构地区：[1]首都医科大学附属北京同仁医院心理科,北京市100730 [2]北京回龙观医院北京大学教学医院临床二科

出　　处：《中国基层医药》2013年第14期2163-2164,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的比较米氮平和氟西汀治疗躯体形式障碍的疗效和安全性。方法将82例诊断躯体形式障碍的患者按入组先后顺序，分为米氮平组（41例）和氟西汀组（41例），进行开放式临床对照研究，疗程均为6周，采用汉密尔顿抑郁量表（HAMD）和症状自评量表（SCL-90）评价疗效，采用药物副反应量表（TESS）评价不良反应。结果米氮平组临床总有效率为88％，氟西汀组为80％，差异无统计学意义（X2=0．13，P〉0．05）。治疗1周时，通过症状自评量表测查，在躯体化、焦虑及总分项中，米氮平组的得分较治疗前下降明显于氟西汀组，差异有统计学意义（t=2．97、3．01、3．73，均P〈0．05）；第6周时，在躯体化、人际关系、抑郁、焦虑、恐怖及总分项中，米氮平组的得分较治疗前下降明显于氟西汀组，差异有统计学意义（t=2．01、2．36、3．25、3．62、2．17、3．84，均P〈0．05）。米氮平组未见明显药物不良反应；氟西汀组出现4例药物不良反应。结论米氮平治疗躯体形式障碍患者较氟西汀起效快，药物不良反应小。Objective To compare the efficacy and safety of mirtazapine and fluoxetine in the treatment of somatoform disorders. Methods 82 patients were randomly divideded into mirtazapine group and fluoxetine group, all the patients were treated for 6 weeks. The efficacy was evaluated with Hamilton depression rating scale and symptom checklist, the side effects were evaluated with treatment emergent symptom scale. Results The total effective rate of the mirtazapine group was 88%. The total effective rate of the fluoxetine group was 80%. There was no difference be- tween the two groups in efficacy （ X2 = 0.13, P 〉 0.05 ）. After the first week of treatment, by Symptom checklist, soma- tization, anxiety and total score of mirtazapine group were significantly lower than the fluoxetine group （ t = 2.97, 3.01,3.73, all P 〈 0.05 ）. After the sixth week of treatment, somatization, interpersonal, depression, anxiety, fear and total score of mirtazapine group were significantly lower than the fluoxetine group （ t = 2.01,2.36,3.25,3.62,2.17, 3.84, all P 〈 0.05 ）. Mirtazapine group had no significant adverse drug reactions. Fluoxetine group had four cases of adverse drug reactions. Conclusion Mirtazapine in the treatment of patients with somatoform disorders has more rapid onset and drug side effects is less than fluoxetine.

关 键 词：躯体型障碍 米氮平 氟西汀 

分 类 号：R749.7[医药卫生—神经病学与精神病学]