CAJ | 학술논문

目的观察不同证型抑郁症在应用5-羟色胺再摄取抑制剂类(SSRI)抗抑郁药基础七联合中药汤剂治疗抑郁症的临床疗效.方法肝郁气滞型70例、肝郁脾虚型 60例、心脾两虚型50例抑郁症患者,在各证型内应用随机数字表法分为两组,即肝郁气滞研究组34例和对照组36例、肝郁脾虚研究组30例和对照组30例、心脾两虚研究组24例和对照组26例;研究组在SSRI的基础上联合不同的中医汤剂,对照组仅给予SSRI抗抑郁药,应用海米尔吨抑郁评定量表(HAMD)、海米尔吨焦虑评定量表(HAMA)、临床总体印象(CGI)在治疗前、治疗后1周末、2周末、4周末、6周末分别进行评定,比较两组间的症状变化、有效率、痊愈率.结果 ①抑郁量表评分:肝郁气滞研究组和对照组、肝郁脾虚研究组和对照组在治疗后4周末[肝郁气滞研究组:(9.01±3.45)、对照组(13.02±4.54);肝郁脾虚研究组(10.22±3.23)、对照组(14.12±3.87)]、6周末[肝郁气滞研究组:(6.02±2.20)、对照组(10.22±2.10);肝郁脾虚研究组(7.25+2.20)、对照组(10.68±3.45)]抑郁量表评分逐渐降低,差异均有统计学意义(P<0.05);且从第1周末开始焦虑症状改善:心脾两虚研究组和对照组的HAMD、HAMA均未见明显变化;②肝郁气滞研究组、肝郁脾虚研究组的有效率(分别为70.6%、66.6%)分别高于各自的对照组(47.2%、40.0%),组间比较差异有统计学意义;心脾两虚研究组和对照组的有效率(分别为58.3%、50.0%)比较,差异无统计学意义(P>0.05);③三个证型的研究组和对照组之间痊愈率比较,差异均无统计学意义(肝郁气滞型分别为41.1%、30.6%,χ2=0.859,P>0.05;肝郁脾虚型分别为40.0%、33.3%,χ2=0.287,P>0.05:心脾两虚型分别为33.3%、26.9%,χ2=0.244,P>0.05).结论肝郁气滞、肝郁脾虚型SSRI联合中药汤剂可提高抑郁症抗抑郁药物的疗效,改善焦虑.
목적 관찰불동증형억욱증재응용5-간색알재섭취억제제류(SSRI)항억욱약기출칠연합중약탕제치료억욱증적림상료효.방법 간욱기체형70례、간욱비허형 60례、심비량허형50례억욱증환자,재각증형내응용수궤수자표법분위량조,즉간욱기체연구조34례화대조조36례、간욱비허연구조30례화대조조30례、심비량허연구조24례화대조조26례;연구조재SSRI적기출상연합불동적중의탕제,대조조부급여SSRI항억욱약,응용해미이둔억욱평정량표(HAMD)、해미이둔초필평정량표(HAMA)、림상총체인상(CGI)재치료전、치료후1주말、2주말、4주말、6주말분별진행평정,비교량조간적증상변화、유효솔、전유솔.결과 ①억욱량표평분:간욱기체연구조화대조조、간욱비허연구조화대조조재치료후4주말[간욱기체연구조:(9.01±3.45)、대조조(13.02±4.54);간욱비허연구조(10.22±3.23)、대조조(14.12±3.87)]、6주말[간욱기체연구조:(6.02±2.20)、대조조(10.22±2.10);간욱비허연구조(7.25+2.20)、대조조(10.68±3.45)]억욱량표평분축점강저,차이균유통계학의의(P<0.05);차종제1주말개시초필증상개선:심비량허연구조화대조조적HAMD、HAMA균미견명현변화;②간욱기체연구조、간욱비허연구조적유효솔(분별위70.6%、66.6%)분별고우각자적대조조(47.2%、40.0%),조간비교차이유통계학의의;심비량허연구조화대조조적유효솔(분별위58.3%、50.0%)비교,차이무통계학의의(P>0.05);③삼개증형적연구조화대조조지간전유솔비교,차이균무통계학의의(간욱기체형분별위41.1%、30.6%,χ2=0.859,P>0.05;간욱비허형분별위40.0%、33.3%,χ2=0.287,P>0.05:심비량허형분별위33.3%、26.9%,χ2=0.244,P>0.05).결론 간욱기체、간욱비허형SSRI연합중약탕제가제고억욱증항억욱약물적료효,개선초필.
Objective To observe the effect of SSRI combined with TCM on the treatment of depression of different TCM types. Methods 70 depressive patients of stagnation of liver qi (SLQ) were randomly recruited into a study (34 cases) and a control group (36 cases); 60 depressive patients of spleen deficiency and liver qi stagnation (SDLQS) were randomly recruited into a study (30 cases) and a control group (30 cases); and SO depressive patients of deficiency of both heart and liver (DBHL) were randomly recruited into a study (24 cases) and a control group (26 cases). Patients in the study group were treated with SSRI and TCM; with the control group was only treated with SSRI. All patients were assessed with HAMD, HAMA and CGI before treatment and after treatment at 1st weekend, 2nd weekend, 4th weekend and 6th weekend. Differences of effective rate and full remission rate were contrasted. Results ①Scores of depression scale decreased in both the study group and the control group of patients with SLQ and SDLQS at the 4th [SLQ study group: (9.01±3.45), control group (13.02±4.54); SDLQS study group (10.22±3.23)、 control group (14.12±3.87)] and 6th [SLQ study group (6.02±2.20), control group (10.22±2.10); SDLQS study group (7.25±2.20) control group (10.68 ± 3.45)] weekend, showing statistical differences; anxiety state has been improved since the 1st weekend; no obvious changes of HAMD and HAMA showed in both the study group and the control group of patients with DBHL; ②Therapeutic effects in the study group were higher than the control group of both patients with SLQ and SDLQS, showing statistical significance; while no difference can be seen between the two group of patients with DBHL; ③ No differences of full remission rate between the study group and the control group of 3 TCM types were found(SLQ:41.1%v30.6%,χ2=0.859,P>0.05; SDLQS:40.0%v33.3, χ2=0.287,P>0.05; DBHL: 33.3%v26.9%,χ2=0.244,P>0.05). ④Significant differences of HAMD and HMDA between the study and the control group of 3 TCM types were found before and after treatment Conclusion SSRI integrated with TCM may promote effective rate and decrease anxiety in patients with SLQ and SDLQS.