【摘要】

摘要 目的：观察米氮平联合艾司西酞普兰在缓解抑郁症患者睡眠障碍中的疗效及安全性。
方法：100例抑郁症伴发睡眠障碍患者随机分为对照组和观察组，每组50例，对照组予以艾司西酞普兰口服治疗，观察组予以米氮平片联合艾司西酞普兰口服治疗，疗程均为8周；比较两组临床疗效、汉密尔顿抑郁量表17项（HAMD-17）评分、匹兹堡睡眠质量指数量表（PSQI）评分、睡眠结构指标及血清去甲肾上腺素（NE）、5-羟色胺（5-HT）及脑源性神经营养因子（BDNF）水平变化，并观察不良反应。
结果：观察组疗效总有效率为96.00%，明显高于对照组的80.00%，有统计学差异（P <0.05）。治疗后，观察组HAMD-17评分、PSQI评分均明显低于对照组（P <0.05），总睡眠时间、睡眠潜伏期、睡眠效率、觉醒次数、SWS时间、REM时间改善优于对照组（P <0.05）。治疗后，观察组血清NE、5-HT、BDNF水平均高于对照组（P <0.05）。两组不良反应发生率对比无统计学差异（P >0.05）。
结论：米氮平联合艾司西酞普兰在缓解抑郁症患者睡眠障碍上疗效显著，可明显改善患者抑郁症状、睡眠结构及睡眠质量，提高血清NE、5-HT、BDNF水平。

【Abstract】

Abstract Objective: To observe the efficacy and safety of mirtazapine combined with escitalopram in relieving sleep disorders in patients with depression.
Methods: 100 patients with depression and sleep disorders were randomly divided into control group and observation group, with 50 cases in each group. Control group was treated with escitalopram orally, and observation group was given mirtazapine combined with escitalopram orally, and they were treated for 8 weeks. The clinical efficacy, Hamilton Depression Scale-17 (HAMD-17) score, Pittsburgh Sleep Quality Index (PSQI) score, sleep structure indicators and levels of serum norepinephrine (NE), 5-hydroxytryptamine (5-HT) and brain-derived neurotrophic factor (BDNF) were compared between the two groups, and the adverse reactions were observed.
Results: The total effective rate of efficacy in observation group was significantly higher than that in control group (96.00% vs 80.00%) (P<0.05). After treatment, the scores of HAMD-17 and PSQI in observation group were significantly lower than those in control group (P<0.05), and the total sleep time, sleep latency, sleep efficiency, wakefulness frequency, SWS time and REM time were better than those in control group (P<0.05). After treatment, the levels of serum NE, 5-HT and BDNF in observation group were higher than those in control group (P<0.05). There was no significant difference in the incidence rate of adverse reactions between the two groups (P>0.05).
Conclusion  : Mirtazapine combined with escitalopram has significant efficacy in relieving sleep disorders in patients with depression, and it can significantly improve depressive symptoms, sleep structure and sleep quality, and enhance levels of serum NE, 5-HT and BDNF.