米氮平联合认知疗法治疗抑郁症对照研究

目的探讨米氮平联合认知疗法治疗抑郁症的临床疗效及安全性。方法将89例抑郁症患者随机分为A组45例,B组44例。两组均口服米氮平治疗,A组联合认知心理治疗,2次.w^-1。观察6w,6mo末随访。于治疗前及治疗2w、4w、6w末采用汉密顿抑郁量表及副反应量表评定临床疗效和不良反应。6mo末随访依据临床疗效总评量表评定复发率。结果治疗6w末,A组显效率82.2%,B组56.8%,A组显著高于B组（P〈0.05）;汉密顿抑郁量表评分两组治疗2w末起均较治疗前有显著下降（P〈0.01）,A组治疗6w末、随访6mo末较B组下降显著（t=-2.417、-5.878,P〈0.05或0.01）;6mo末随访,A组汉密顿抑郁量表评分仍保持较低水平,而B组较治疗6w末反而有所增加;B组复发率显著高于A组（P〈0.05）。结论米氮平配合认知疗法治疗抑郁症是一种经济、安全有效、依从性好的方法。

A control study of mitrazapine combined with cognitive therapy in the treatment of depression

Objective To explore the efficacy and safety of mitrazapine combined with cognitive therapy(CT)in the treatment of depression.Methods 89 patients with depression were randomly divided into group A(n=45)treated with combination of mitrazapine and CT and group B(n=44)with mitrazapine only,twice/week,observed for 6 weeks,and followed up since the end of the 6th month.Efficacies were assessed with the Hamilton Depression Scale(HAMD)and adverse reactions with the Treatment Emergent Symptom Scale(TESS)before treatment and at the ends of the 2nd,4th and 6th week.Relase rate was assessed with the Clinical Global Impression(CGI)at the end of the 6 month follow-up.Results At the end of the 6th week,excellence rates were 82.2% in the group A and 56.8% in the group B,the former was significantly higher than the latter(P<0.05);since the end of the 2nd week,the HAMD scores of both groups lowered more significantly compared with pre-treatment(P<0.01)and those did more significantly in the group A than B since the end of 6 week treatment and 6 month follow-up(P<0.05 or 0.01).At the end of 6 month follow-up,the HAMD score maintained lower level in group A and was higher compared with the end of 6-week treatment in the group B;Relase rate was significantly higher in the group B than in the A(P<0.05).Conclusion The combination of CT and mitrazapine is an economical,safe,effective,well-tolerated therapy for depression.