米氮平治疗广泛性焦虑症患者的临床疗效及对患者防御方式与生活质量的改变

目的研究米氮平对广泛性焦虑症的治疗效果，并探讨其对患者防御方式与生活质量的影响。方法对32例广泛性焦虑症患者给予米氮平治疗，于治疗前和第1、2、4、6周末利用汉密顿焦虑量表（HAMA）评估临床疗效，同时在治疗前和治疗第6周末进行防御方式（DSQ量表）和生活质量（SF-36量表）调查。结果32例广泛性焦虑症患者中痊愈21例（65．6％），显著进步7例（21．9％），有效4例（12．5％），显效率达87．5％，有效率达100％。第1、2、4、6周末与治疗前相比，HAMA评分均具有显著性差异（P〈0.05）；不良反应较少。与治疗前相比，第6周末患者成熟型防御机制评分升高，不成熟型和中间型防御机制评分降低，差异均有统计学意义（P〈0.05）；生活质量评估中一般健康（GH）、精力（VT）、社会功能（SF）、情感职能（RE）、精神健康（MH）等评分也均升高（P〈0．05）。结论米氮平能快速有效地治疗广泛性焦虑症，而且能促进患者防御机制向成熟型转变，提高生活质量。

Clinical efficacy and improvement of life quality of mirtazapine for treating general anxiety disorder.

Objective To explore the efficacy and improvement of defense styles and life quality of general anxiety disorder treated by Mirtazapine. Methods 32 patients with anxiety were treated by Mirtazapine for 6 weekends, the clinical effect were evaluated with Hamilton anxiety scale （HAMA） baseline and the treatment 1, 2, 4, 6 weekend; defense styles and life quality were evaluated with Defense Style Quest ionnaire （DSQ） and Medical Outcomes Study short-form 36 （SF-36） in the baseline and treatment sixth weekend. Results The obvious effective rate of mirtazapine for GAD was 87.5%. Anxiety patients tended to use immature defense mechanism. The scores of HAMA in the next 1, 2, 4, 6 weekend was decreased than baseline, mature defense, general health （GH）, vitality （VT）, social functioning （SF）, emotional role （RE） and mental health （MH） in the sixth weekend were all significantly higher than before treatment （P〈0. 05）. Conclusion Mirtazapiue is considered as a rapid, safe and effective drug for GAD, leading patients to adopt mature defense mechanism and improve the quality of life.