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1、临床医学论文■米氮平联合认知疗法治疗抑郁症对照研究【摘要】口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・l。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%,E组56.8%,A组显着高于E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着下降(P<0.01),A组治疗6w末、随访6mo末较B组下降显着(=2.417
2、、-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末反而冇所增加；B组复发率显着高于A组(PV0.05)。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。【关键词】抑郁症；米氮平；认知疗法Acontrolstudyofmitrazapinecombinedwithcognitivetherapyinthetreatmentofdepression【Abstract1ObjectiveToexploretheefficacyandsafetyofmitrazapinecombinedwithcognitivet
3、herapy(CT)inthetreatmentofdepression.Methods89patientswithdepressionwererandomlydividedintogroupA(n二45)treatedwithcombinationofmitrazapineandCTandgroupB(n=44)withmitrazapineonly,twicc/wcck,observedfor6weeks,andfollowedupsincetheendofthe6thmonth.EfficacieswereassessedwiththeHami1tonDepressionScale(
4、HAMD)andadversereactionswiththeTreatmentEmergentSymptomScale(TESS)beforetreatmentandattheendsofthe2nd,4thand6thweek.RelaseratewasassessedwiththeClinicalGlobalImpression(CGI)attheendofthe6monthfollowup.ResultsAttheendofthe6thweek,excellencerateswere82.2%inthegroupAand56.8%inthegroupB,theformerwassi
5、gnificantlyhigherthanthelatter(P<0.05)；sincetheendofthe2ndweek,theHAMDscoresofbothgroupsloweredmoresignificantlycomparedwithpretreatment(P<0.01)andthosedidmoresignificantlyinthegroupAthanBsincetheendof6weektreatmentand6monthfollowup(P<0.05or0.01)・Attheendof6monthfollowup,theHAMDscoremaintained1owe
6、rlevelingroupAandwashighercomparedwiththeendof6weektreatmentinthegroupB；RclascratewassignificantlyhigherinthegroupBthanintheA(Pv0・05)・ConclusionThecombinationofCTandmitrazapineisaneconomicaLsafe,effective,we11toleratedtherapyfordepression.[Keywords]Depression；mitrazapine；cognitivetherapy抑郁症是危害人们心身
7、健康的一种常见的精神疾病，发病率高达6%〜11%,在综合医院心理障碍就诊患者中占12.5%,躯体疾病患者中患病率为25%[1]。目前已冇多种新型抗抑郁药上市，国外文献报道认知疗法联合抗抑郁药物治疗抑郁症疗效明显优于单纯应用抗抑郁药物[2,3],而国内类似研究报道较少。木研究应用米氮平联合认知疗法治疗抑郁症进行了对照研究，以探讨其临床疗效及安全性，现将结果报道如21对象与方法1.1对象选取2006年1月〜2008年1月在我
