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目的：探讨米氮平联合阿立哌唑治疗难治性抑郁症的临床疗效和安全性。方法将94例难治性抑郁症患者随机分为两组，观察组口服米氮平联合阿立哌唑治疗，对照组单用米氮平治疗，观察8周。采用汉密顿抑郁量表评定临床疗效，副反应量表评定不良反应。结果治疗前两组汉密顿抑郁量表总分及各因子分比较差异均无显著性（P＞0．05），治疗后观察组汉密顿抑郁量表总分及各因子分均较治疗前显著下降（P＜0．01），且显著低于对照组（P＜0．05或0．01）。两组不良反应较轻微，患者均可耐受。结论米氮平联合阿立哌唑治疗难治性抑郁症具有增效作用，起效快，疗效显著，安全性高，显著优于单用米氮平治疗。“,”Objective To explore the efficacy and safety of mitrazapine coupled with small‐dose aripiprazole in treatment‐resistant depression (TRD) .Methods Ninety‐four TRD patients were randomly assigned to two groups ,observation group took orally mitrazapine coupled with aripiprazole and control did single mitrazapine for 8 weeks .Efficacies were assessed with the Hamilton Depression Scale (HAMD) and adverse reactions with the Treatment Emergent Symptom Scale (TESS) .Results There were no significant group differences in the total and each factor score before treatment (P> 0 .05) , those lowered more significantly after treatment compared with pretreatment in observation group (P <0 .01) ,and those were significantly lower than in control group (P < 0 .05 or 0 .01) .Adverse reactions of both groups were mild and tolerant .Conclusion Mitrazapine coupled with aripiprazole has a synergism , takes effect more rapidly ,and has an evident effect and higher safety compared with single mitrazapine in treatment‐resistant depression .