目的 探究阿戈美拉汀片联合米氮平片治疗抑郁症的临床疗效。方法 选取2019年3月—2020年3月江汉油田总医院心理精神科收治100例抑郁患者，将所有患者按照随机数字表法分为对照组和治疗组，每组各50例。对照组睡前口服米氮平片，初始剂量为15 mg/d，1周后剂量增至30 mg/d。治疗组在对照组治疗的基础上睡前口服阿戈美拉汀片，初始剂量为25 mg/次，1次/d，若治疗两周后症状没有改善，可增加剂量至50 mg/次，1次/d。两组患者均持续治疗6个月。观察两组的临床疗效，比较两组的抑郁程度和去甲肾上腺素（NE）、脑源性神经营养因子（BDNF）、谷氨酸（Glu）和γ-氨基丁酸（GABA）水平。结果 治疗后，治疗组的总有效率为84.00%，明显高于对照组总有效率66.00%（P＜0.05）。治疗后，两组患者汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）评分均明显降低（P＜0.05），治疗组患者HAMD、HAMA评分均明显低于对照组（P＜0.05）。治疗后，两组患者血清NE、BDNF、GABA水平均明显升高，Glu水平明显降低（P＜0.05），且治疗组患者血清NE、BDNF、GABA水平高于对照组，Glu水平明显低于对照组（P＜0.05）。结论 阿戈美拉汀片联合米氮平片治疗抑郁症具有较好的疗效，能有效缓解患者的抑郁程度，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

湖北省自然科学基金资助项目(2018CFB578)