米氮平与帕罗西汀治疗难治性抑郁对照试验.docVIP

米氮平与帕罗西汀治疗难治性抑郁对照试验 　　【摘 要】 目的:观察米氮平对难治性抑郁的疗效和不良反应。方法:将符合入组标准的80例患者随机分成米氮平组和帕罗西汀组各40例。于治疗前和治疗第1、4、8周末采用汉密尔顿抑郁量表(HAMD)17项评定疾病严重程度和疗效，采用不良反应量表(TESS)评定药物不良反应，采用生活质量综合评定问卷(WHO.QOL-100)评定生活质量。结果:（1）米氮平组痊愈13 例，显著进步13例，进步10 例，显效率57.5%；帕罗西汀组痊愈8 例，显著进步9 例,进步13 例,显效率42.5%；两组间显效率比较χ2=4.07，P=0.044。(2)治疗1周时，米氮平组与帕罗西汀组之间HAMD总分的差异有统计学意义，但是在治疗8周末差异没有统计学意义。(3)治疗8周末，米氮平组WHOQOL心理领域、社会关系、环境因素因子分均高于帕罗西汀组，差异有统计学意义。(4)在不良反应方面,食欲增加、性功能障碍和睡眠障碍的发生率组间差异有统计学意义，但是均较轻微。结论:与帕罗西汀相比，米氮平治疗难治性抑郁症起效快，疗效好，安全性好，且能显著改善患者的生存质量。? 　　【关键词】 难治性抑郁症;米氮平;帕罗西汀;生存质量;双盲研究? 　　中图分类号：R749.41 文献标识码：A 文章编号：1000-6729(2007)012-00878-03? 　　Comparison of Mirtazapine and Paroxetine in the Treatment of Patients with Refractory Depression? 　　LI Jing?1，MENG Hua-Qing?1，LIU Fang?2? 　　1 Center of Mental Health,The First Affiliated Hospital，Chongqing University of Medical Sciences，Chongqing 410016? 　　2 Department of Psychiatry，First Affiliated Hospital of Kunming Medical College，Kunming 650031? 　　 　　【Abstract】Objective: To study the efficacy and safety of mirtazapine and paroxetine in patients with refractory depression. Methods： 80 patients with refractory depression were randomly divided into Mirtazapine and Paroxetine groups for 8 week double-blind treatment. At baseline, the ends of week 1，4 and 8, the efficacy was assessed with Hamilton Depression Scale ( HAMD),adverse effects with Treatment Emergent Symptom Scale (TESS) and quality of life with the WHO Quality of Life (WHOQOL) .Results :（1）The difference of HAMD score between mirtazapine and Paroxetine groups was statistically significant at the ends of week 1，but not so at the end of week 8.（2）At the end of week 8，scores of the WHOQOL psychological domain，social relationship and environmental factor were significantly greater in the mirtazapine group than the Paroxetine group.（3）There were higher rate of increased appetite, sexual disturbance and lower rate of insomnia in mirtazapine group in comparison to paroxetine group but these adverse effects were mild. Concl