目的 探讨米氮平联合奥氮平治疗躯体形式障碍的疗效与安全性.方法 将78例躯体形式障碍患者采用抽签法随机分成两组,每组39例.两组均予以米氮平治疗,研究组在此基础上联合奥氮平治疗.观察8周.于治疗前后采用症状自评量表评定临床疗效,副反应量表评定不良反应.结果 治疗8周末,研究组总有效率为94.9%,对照组为71.8%,研究组显著高于对照组(P<0.01).研究组治疗2周末起,对照组治疗4周末起症状自评量表的躯体化、抑郁、焦虑因子分较治疗前显著降低(P<0.05或0.01),治疗4周、8周末研究组显著低于对照组(P<0.05或0.01),其他时点两组比较差异无显著性(P>0.05).研究组嗜睡发生率显著高于对照组(P<0.05),失眠发生率显著低于对照组(P<0.05),治疗各时点两组副反应量表评分比较差异无显著性(P>0.05).结论 米氮平联合奥氮平治疗躯体形式障碍疗效显著,安全性高,优于单用米氮平治疗.%Objective To explore the efficacy and safety of mirtazapine combined with olanzapine in the treatment of somatoform disorders (SD). Methods Seventy-eight refractory SD patients were divided into two groups of 39 ones each according to sortition. Both groups were treated with mirtazapine and on this basis research group was plus olanzapine for 8 weeks. Efficacies were assessed with the Symptom Checklist-90 (SCL-90) before and after treatment and adverse reactions with the Treatment Emergent Symptom Scale (TESS). Results At the end of the 8th week treatment total effective rate was respectively 94.9% in research and 71.8% in control group and the former significantly higher than the latter (P<0.01). The SCL-90 score on somatization,depression and anxiety at the end of the 2nd week in research and at 4th in control group lowered more significantly compared with pretreatment (P<0.05 or 0.01),those were significantly lower in research than in control group (P<0.05 or 0.01),and those had no significant group differences at other time points (P>0.05). The incidence of hypersomnia was significantly higher (P<0.05) and that of insomnia lower (P<0.05) in research than in control group,the TESS scores at all time points had no significant group differences (P>0.05). Conclusion Mirtazapine in combination with olanzapine has an evident effect and higher safety compared with single mirtazapine in the treatment of somatoform disorders.
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