米氮平对抑郁症伴睡眠障碍患者抑郁症状、PSQI评分及睡眠结构的影响

张永涛

摘要目的：探讨米氮平治疗抑郁症伴睡眠障碍的临床效果。方法：选取2018年1月至2019年6月阜宁县第三人民医院收治的抑郁症伴睡眠障碍患者80例作为研究对象，按照随机双盲法分为对照组和观察组，每组40例。对照组以艾司西酞普兰治疗，观察组以米氮平治疗，比较2组患者抑郁症状、睡眠质量及睡眠结构。结果：观察组治疗后汉密顿抑郁量表（HAMD）评分（684±121）分低于对照组的（836±175）分，兹堡睡眠质量指数量表（PSQI）评分（521±072）分低于对照组的（846±126）分，差异有统计学意义（P<005）。观察组治疗后实际睡眠时间、睡眠效率高于对照组，睡眠潜伏期短于对照组，差异有统计学意义（P<005）。结论：米氮平治疗抑郁症伴睡眠障碍具有明显效果，能够减轻患者抑郁症状，改善睡眠质量及睡眠结构，临床价值高，值得推广。

关键词米氮平;抑郁症;睡眠障碍;抑郁症状;睡眠质量

Effect of Mirtazapine on Depressive Symptoms，PSQI score and Sleep Structure of Patients with Depression and Sleep Disorder

ZHANG Yongtao

（The third people′s Hospital of Funing County，Yancheng 224400，China）

AbstractObjective：To investigate the clinical effect of mirtazapine in the treatment of depression with sleep disorderMethods：80 patients with depression and sleep disorder admitted to the third people′s Hospital of Funing County from January 2018 to June 2019 were selected as the study objectAccording to the doubleblind method，they were divided into control group and observation group，with 40 cases in each groupThe control group was treated with escitalopram and the observation group was treated with mirtazapineResults：The scores of HAMD（684±121）and PSQI（521±072）in the observation group were significantly lower than those in the control group（P<005）After treatment，the actual sleep time and sleep efficiency of the observation group were higher than those of the control group，and the sleep latency was shorter than that of the control group（P<005）Conclusion：Mirtazapine has a significant effect in the treatment of depression with sleep disorderIt can reduce the depressive symptoms，improve the sleep quality and sleep structureIt has a high clinical value and is worth popularizing.

KeywordsMirtazapine; Depression; Sleep disorders; Depressive symptoms; Sleep quality

中圖分类号：R7494;R33863文献标识码：Adoi：10.3969/j.issn.2095-7130.2020.06.010

抑郁症是临床常见的精神障碍性疾病，属高复发性疾病。睡眠障碍是抑郁症常见症状，患病率高达90%，并为首发症状，也是造成抑郁症患者自杀的首要原因[1]。因此临床治疗时，在起到抗抑郁作用同时，并能改善患者睡眠质量是临床研究热点。米氮平是一种去甲肾上腺素（Norepinephrine，NE）能积极特异性5羟色胺能抗抑郁药物，并在1996年被美国食品药品监督管理局批准用于治疗抑郁症，获得一定效果。对抑郁症伴睡眠障碍患者，米氮平是否具有作用，仍需临床进一步研究。现本研究对抑郁症伴睡眠障碍患者采用米氮平治疗，旨为临床用药提供依据，现将结果报道如下。

1资料与方法

11一般资料选取2018年1月至2019年6月阜宁县第三人民医院收治的抑郁症伴睡眠障碍患者80例作为研究对象，按照随机双盲法分为对照组和观察组，每组40例。对照组中男23例，女17例;年龄24～65岁，平均年龄（4184±629）岁;病程6个月至5年，平均病程（217±025）年。……