摘要
目的:探讨米氮平联合文拉法辛对抑郁症伴失眠患者抑郁症状、睡眠质量及神经递质的影响。方法:选取2020年6月10日~2022年12月22日期间于某院治疗的84例抑郁症伴失眠患者作为研究对象,采用随机数字表法分为对照组和观察组,每组42例。对照组患者给予盐酸文拉法辛缓释片治疗,观察组患者在对照组治疗基础上给予米氮平片治疗,两组均连续治疗8周。比较两组患者汉密尔顿抑郁量表17项(HAMD-17)评分、匹兹堡睡眠质量指数(PSQI)评分、睡眠结构分期[睡眠阶段1(S1)、2(S2)、3(S3)、4(S4)和快速眼球运动(REM)睡眠阶段时间]、神经递质[去甲肾上腺素(NE)、5-羟色胺(5-HT)]水平、临床疗效及不良反应发生情况。结果:治疗8周后,两组患者HAMD-17评分和PSQI评分均降低(P<0.05),且观察组低于对照组(P<0.05);观察组患者 S1+S2 时间短于对照组(P<0.05),S3+S4 和 REM 时间均长于对照组(P<0.05);两组患者血清 NE 和 5-HT 水平均升高(P<0.05),且观察组高于对照组(P<0.05);观察组患者治疗总有效率(95.24%)高于对照组(80.95%,P<0.05);两组患者不良反应总发生率比较无统计学差异(χ^(2)=0.553,P=0.457)。结论:米氮平联合文拉法辛治疗抑郁症伴失眠患者临床疗效较佳,可显著改善患者情绪状态、睡眠质量,延长深度睡眠时间,调节血清神经递质水平,且未增加不良反应的发生风险。
Objective:To investigate the effects of mirtazapine combined with venlafaxine on depressive symptom,sleep quality and neurotransmitters in patients with depression accompanied by insomnia.Methods:A total of 84 patients with depression accompanied by insomnia treated in a hospital from June 10,2020 to December 22,2022 were selected and assigned to the control group and observation group by random number table method,with 42 patients in each group.The control group was treated with venlafaxine hydrochloride sustained-release tablets,and the observation group was treated with mirtazapine tablets in addition to the treatment given in the control group.Both groups were treated for 8 consecutive weeks.The Hamilton depression rating scale-17(HAMD-17)score,Pittsburgh sleep quality index(PSQI)score,sleep structure staging[time for sleep stage 1(S1),2(S2),3(S3),4(S4)and rapid eye movement(REM)sleep stage],neurotransmitter levels[norepinephrine(NE),5-hydroxytryptamine(5-HT)],clinical efficacy and adverse reactions were compared between the two groups.Results:After 8 weeks of treatment,the scores of HAMD-17 and PSQI were decreased in the two groups(P<0.05),with the observation group showing lower scores than the control group(P<0.05).The time for S1+S2 in the observation group was shorter than that in the control group(P<0.05),while the time for S3+S4 and REM was longer than that in the control group(P<0.05).The serum levels of NE and 5-HT were increased in the two groups(P<0.05),with the observation group showing higher levels than the control group(P<0.05).The total response rate in the observation group(95.24%)was higher than that in the control group(80.95%,P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(χ^(2)=0.553,P=0.457).Conclusion:Mirtazapine combined with venlafaxine shows better clinical efficacy in treating patients with depression accompanied by insomnia,significantly improving emotional states and sleep quality,prolonging deep sleep time,regulating serum neurotransmitter levels,without increasing the risk of adverse reactions.
作者
郭俊峰
朱文佳
赵指亮
马衡
GUO Jun-feng;ZHU Wen-jia;ZHAO Zhi-liang;MA Heng(The Ninth Psychiatry Department,Zhumadian Second People's Hospital(the Afilated Encephalopathy Hospital to Zhengzhou University),Zhumadian 463000;Clinical Psychology Department,Zhumadian Second People's Hospital(the Afilated Encephalopathy Hospital to Zhengzhou University),Zhumadian 463000,China)
出处
《中国合理用药探索》
2025年第2期73-78,共6页
Chinese Journal of Rational Drug Use
基金
河南省医学科技攻关计划联合共建项目(LHGJ20210995)。
关键词
米氮平
文拉法辛
抑郁症
失眠
情绪状态
睡眠结构指标
神经递质
mirtazapine
venlafaxine
depression
insomnia
emotional state
sleep architecture metrics
neurotransmitter
