目的 探究阿戈美拉汀片聯(lián)合米氮平片治療抑郁癥的臨床療效。方法 選取2019年3月—2020年3月江漢油田總醫(yī)院心理精神科收治100例抑郁患者，將所有患者按照隨機(jī)數(shù)字表法分為對照組和治療組，每組各50例。對照組睡前口服米氮平片，初始劑量為15 mg/d，1周后劑量增至30 mg/d。治療組在對照組治療的基礎(chǔ)上睡前口服阿戈美拉汀片，初始劑量為25 mg/次，1次/d，若治療兩周后癥狀沒有改善，可增加劑量至50 mg/次，1次/d。兩組患者均持續(xù)治療6個月。觀察兩組的臨床療效，比較兩組的抑郁程度和去甲腎上腺素（NE）、腦源性神經(jīng)營養(yǎng)因子（BDNF）、谷氨酸（Glu）和γ-氨基丁酸（GABA）水平。結(jié)果 治療后，治療組的總有效率為84.00%，明顯高于對照組總有效率66.00%（P＜0.05）。治療后，兩組患者漢密爾頓抑郁量表（HAMD）、漢密爾頓焦慮量表（HAMA）評分均明顯降低（P＜0.05），治療組患者HAMD、HAMA評分均明顯低于對照組（P＜0.05）。治療后，兩組患者血清NE、BDNF、GABA水平均明顯升高，Glu水平明顯降低（P＜0.05），且治療組患者血清NE、BDNF、GABA水平高于對照組，Glu水平明顯低于對照組（P＜0.05）。結(jié)論 阿戈美拉汀片聯(lián)合米氮平片治療抑郁癥具有較好的療效，能有效緩解患者的抑郁程度，降低Glu水平，提高NE、BDNF、GABA水平。

Objective To investigate the clinical efficacy of Agomelatine Tablets combined with Mirtazapine Tablets in treatment of depression. Methods Patients (100 cases) with depression in Jianghan Oilfield General Hospital from March 2019 to March 2020 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were po administered with Mirtazapine Tablets, with the initial dose 15 mg/d, then increased to 30 mg/d after 1 week. Patients in the treatment group were po administered with Agomelatine Tablets on the basis of the control group, with the initial dose 25/time, once daily. If the symptoms did not improve after two weeks of treatment, the dose could be increased to 50 mg/time, once daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and the degree of depression, the levels of NE, BDNF, Glu, and GABA in two groups were compared. Results After treatment, the total effective rate of the treatment group was 84.00%, which was significantly higher than 66.00% of the control group (P < 0.05). After treatment, the scores of HAMD and HAMA in two groups were significantly decreased (P < 0.05), and the scores of HAMD and HAMA in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of NE, BDNF, and GABA in two groups were significantly increased, but the level of Glu in two groups were significantly decreased (P < 0.05). The serum levels of factors in the treatment group were better than those in the control group (P < 0.05). Conclusion Agomelatine Tablets combined with Mirtazapine Tablets has clinical curative effect in treatment of depression, can effectively alleviate the degree of depression, reduce the level of Glu, and improve the levels of NE, BDNF and GABA.

R971

湖北省自然科學(xué)基金資助項(xiàng)目(2018CFB578)