米氮平联合西酞普兰治疗抑郁症患者睡眠障碍的临床观察  

Clinical Observation of Mirtazapine Combined with Citalopram in the Treatment of Sleep Disorder of Depressive Patients

作　　者：顾翠[1] 可秦 张平[1] 师梦[1] 

机构地区：[1]玉溪市人民医院神内一科,云南玉溪653100

出　　处：《中国药房》2017年第5期670-673,共4页China Pharmacy

摘　　要：目的:探讨西酞普兰联合米氮平治疗抑郁症患者睡眠障碍临床疗效和安全性。方法:选取抑郁症伴睡眠障碍患者165例,按随机数字表法分为对照组(82例)和治疗组(83例)。对照组患者给予草酸艾司西酞普兰片10 mg,每晚1次,根据患者病情,每日剂量可增至20 mg;治疗组患者在对照组的基础上加用米氮平片15 mg,每晚1次,1周后剂量增至30 mg。两组患者均持续治疗6个月。观察两组患者治疗前后汉密尔顿抑郁量表17项(HAMD-17)、蒙哥马利抑郁评定量表(MADRS)评分,采用匹兹堡睡眠质量指数量表(PSQI)评估两组患者治疗前后的睡眠质量,采用多导睡眠仪测定患者治疗前后睡眠结构,比较两组患者临床疗效及不良反应发生情况。结果:治疗前,两组患者HAMD-17、MADRS、PSQI评分及睡眠结构指标比较,差异均无统计学意义(P>0.05);治疗后,两组患者上述评分及指标均显著改善,且治疗组显著优于对照组,差异均有统计学意义(P<0.05)。治疗组患者临床总有效率为97.47%,显著高于对照组的78.95%,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:米氮平联合西酞普兰治疗抑郁症患者睡眠障碍疗效显著,可明显改善抑郁症患者睡眠结构、调整睡眠周期、提高睡眠质量,且安全性较好。OBJECTIVE：To investigate the clinical efficacy and safety of mirtazapine combined with citalopram in the treatment of sleep disorder in depressive patients.METHODS：One hundred and sixty-five depressive patients with sleep disorder were selected and divided into control group（82 cases） and treatment group（83 cases） according to random number table.Control group took Escitalopram oxalate tablet 10 mg,once every night,increasing to 20 mg according to disease condition;treatment group was additionally given Mirtazapine tablet 15 mg,once every night,increasing to 30 mg one week later.Both groups received treatment for consecutive 6 months.HAMD-17 and MADRS were observed in 2 groups before and after treatment,and the sleep quality of 2 groups were evaluated by PSQI before and after treatment;the sleep structure was measured by using polysomnography before and after treatment;clinical efficacies and the occurrence of ADR were compared between 2 groups.RESULTS：Before treatment,there was no statistical significance in HAMD-17,MADRS and PSQI score,sleep structure between 2 groups（P〉0.05）;after treatment,above scores and indexes of 2 groups were all improved significantly,and the treatment group was significantly better than the control group,with statistical significance（P〈0.05）.Total response rate of treatment group was 97.47%,which was significantly higher than 78.95%of control group,with statistical significance（P〈0.05）.There was no statistical significance in the incidence of ADR between 2 groups（P〉0.05）.CONCLUSIONS：Citalopram combined with mirtazapine shows significant therapeutic efficacy for sleep disorder of depressive patients,and can significantly improve sleep structure,adjust sleep cycle and improve sleep quality with good safety.

关 键 词：西酞普兰 米氮平 抑郁症 睡眠障碍 临床疗效 安全性 

分 类 号：R453.9[医药卫生—治疗学]