【摘要】

【摘要】目的：米氮平对抑郁症伴睡眠障碍患者抑郁症状及匹兹堡睡眠质量指数量表(PSQI)评分和睡眠结构影响。
方法：研究对象选取我院2016年1月到2017年2月间收治的抑郁症伴睡眠障碍患者90例，采用随机数字法将其分为对照组和观察组，每组各45例。对照组患者口服草酸艾司西酞普兰片治疗，在此基础上，观察组患者口服米氮平治疗。比较两组患者的治疗总有效率和不良反应发生率，同时比较治疗前后的蒙哥马利抑郁评定量表(MADRS)评分、PSQI评分及各睡眠结构因子。
结果：观察组的治疗总有效率(91.11%)明显高于对照组(73.33%)(χ2=4.86,P=0.02)，治疗后，观察组的MADRS评分和PSQI评分均明显低于对照组(P<0.01)，实际睡眠时间、睡眠效率、NREM中S3+S4时间、REM时间均明显高于对照组(P<0.01)，睡眠潜伏期、觉醒时间、NREM中S1+S2时间均明显低于对照组(P<0.01)；两组患者的不良反应发生率比较无明显差异(P>0.05)。
结论：米氮平对抑郁症伴睡眠障碍患者的疗效显著，能够明显改善患者抑郁症状，改善睡眠质量及纠正睡眠结构，且治疗安全性较高，值得在临床推广。

【Abstract】

[Abstract]Objective:To observe the effect of mirtazapine on depressive symptoms and Pittsburgh Sleep Quality Index (PSQI) score and sleep structure in patients with depression and sleep disorders.
Methods:The subjects were 90 patients with depression and sleep disorders admitted in our hospital from January 2016 to February 2017,randomly divided into control group and observation group, 45 cases in each group. The patients in the control group were treated with estradiol oxalate tablets.on this basis, the patients in the observation group were treated with oral mirtazapine.compared the two groups of the total effective rate and the incidence of adverse reactions,and compared before and after treatment of the Montgomery Depression Rating Scale (MADRS) score, PSQI score and sleep structural factors.
Results:The total effective rate (91.11%) in the observation group was significantly higher than that in the control group (73.33%) (χ2=4.86,P=0.02). After treatment,the observation group of the MADRS score and PSQI score were significantly lower than the control group (P<0.01). The sleep time, awakening time and S1 + S2 time in NREM were significantly higher than those in the control group (P<0.01), the actual sleep time, the sleep efficiency, S3+ S4 time in NREM significantly lower than the control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).
Conclusion  :Mirtazapine is effective in patients with depression and sleep disorders, which can significantly improve the symptoms of depression, improve sleep quality and correct sleep structure, and the treatment is safe and worthy of clinical promotion.