米氮平和氟西汀治疗伴抑郁的心血管神经症的临床观察

目的：评价米氮平治疗伴抑郁的心血管神经症的临床疗效和安全性。方法：将60例伴抑郁的心血管神经官能症患者随机分为米氮平组和氟西汀组，进行为期42天的治疗观察。采用汉密顿抑郁量表（HAMD）、心血管神经症积分评价临床疗效，采用TESS、体检及实验室检查评价安全性，分别在治疗前和治疗后第7、14、28、42天评定疗效和不良反应。结果：（1）两组治疗后HAM／）和心血管神经症积分均明显低于治疗前，差异有统计学意义（P〈0．01）。（2）治疗后第7天，米氮平组HAMD量表总分、焦虑评分、迟滞评分、睡眠紊乱评分、心血管神经症积分均较氟西汀组低，且有统计学意义（P〈0．01）；研究结束时，上述指标的组间差异没有统计学意义。（3）经过42天治疗，有效率和治愈率米氮平组分别为83．3％和66．7％，氟西汀组分别为80．0％和63．3％，差异没有统计学意义（P〉0．05）。（4）安全性评定：两组比较差异无统计学意义（P〉0．05）。结论：米氮平治疗伴抑郁的心血管神经症有效而安全，且起效时间早于氟西汀。

Mirtazapine and Fluoxetine in the Treatment of Cardiovascular Neurosis with Depression

Objective:To evaluate the efficacy and safety of mirtazapine in the treatment of cardiovascular neurosis with depression.Methods:60 patients with cardiovascular neurosis with depression were randomly treated with mirtazapine or fluoxetine.The scores of cardiovascular neurosis,HAMD were measured at baseline,day 7,14, 28,and 42.Efficacy was evaluated with HAMD and scores of cardiovascular neurosis.Safety was monitored by TESS,physical and laboratory examinations.Results:(1)The HAMD and scores of cardiovascular neurosis for both groups were significantly decreased after treatment(P<0.01).(2)HAMD,the scores of cardiovascular neurosis, anxiety,depression in mirtazapine group were statistically lower than those in fluoxetine group at day 7.These differences became insignificant at the end of the trial.(3)The response rates of mirtazapine and fluoxetine were 83.3% and 80.0% respectively.(4)Safety measures were not significantly different between two groups.Conclusion: Mirtazapine is safe and effective in the treatment of cardiovascular neurosis with depression,and its effect appears earlier than that of fluoxetine.