CAJ | 학술논문

目的：探讨疏肝解郁胶囊在治疗血管迷走性晕厥伴轻中度抑郁、焦虑患者时安全性和有效性是否优于氟哌噻吨美利曲辛片。方法：选取伴有轻中度抑郁、焦虑症状的血管迷走性晕厥患者89例，随机分成A组疏肝解郁胶囊组、B组氟哌噻吨美利曲辛组和C组对照组三组。在血管迷走性晕厥常规治疗基础上，三组分别治疗8周后，观察各组晕厥转阴率；进行汉密尔顿24项抑郁量表（HAMD-24）和汉密尔顿焦虑量表（HAMA）评分，分别计算减分率；以副反应量表（TESS）评价治疗期间两种药物不良反应。治疗后随访12个月，观察各组晕厥的复发率。结果：与治疗前相比，A、B组治疗后HAMD-24和HAMA评分显著降低（P<0.05）；治疗后与C组相比，A、B组直立倾斜试验转阴率及HAMD-24和HAMA减分率均显著增加（P<0.05）；与B组相比，A组转阴率及HAMD-24和HAMA减分率增加更为显著（P<0.05)。治疗后，A组TESS评分明显低于B组（P<0.05）。随访24个月，A、B组晕厥复发率明显低于C组（P<0.05），且A组明显优于B组（P<0.05）。结论：疏肝解郁胶囊可用于治疗血管迷走性晕厥伴轻中度抑郁、焦虑，其疗效与安全性可能优于氟哌噻吨美利曲辛片。
목적：탐토소간해욱효낭재치료혈관미주성훈궐반경중도억욱、초필환자시안전성화유효성시부우우불고새둔미리곡신편。방법：선취반유경중도억욱、초필증상적혈관미주성훈궐환자89례，수궤분성A조소간해욱효낭조、B조불고새둔미리곡신조화C조대조조삼조。재혈관미주성훈궐상규치료기출상，삼조분별치료8주후，관찰각조훈궐전음솔；진행한밀이돈24항억욱량표（HAMD-24）화한밀이돈초필량표（HAMA）평분，분별계산감분솔；이부반응량표（TESS）평개치료기간량충약물불량반응。치료후수방12개월，관찰각조훈궐적복발솔。결과：여치료전상비，A、B조치료후HAMD-24화HAMA평분현저강저（P<0.05）；치료후여C조상비，A、B조직립경사시험전음솔급HAMD-24화HAMA감분솔균현저증가（P<0.05）；여B조상비，A조전음솔급HAMD-24화HAMA감분솔증가경위현저（P<0.05)。치료후，A조TESS평분명현저우B조（P<0.05）。수방24개월，A、B조훈궐복발솔명현저우C조（P<0.05），차A조명현우우B조（P<0.05）。결론：소간해욱효낭가용우치료혈관미주성훈궐반경중도억욱、초필，기료효여안전성가능우우불고새둔미리곡신편。
This study was aimed to observe the safety and effectiveness ofShugan Jieyu Capsules in the treatment of vasovagal syncope (VVS) with mild-to-moderate depression and anxiety, and to compare the effect with Flupentixol and Melitracen Tablets. A total of 89 VVS cases with mild-to-moderate depression and anxiety were randomly divided into 3 groups, which were group A (Shugan Jieyu Capsules group), group B (Flupentixol and Melitracen Tablets) and group C (control group). Based on the conventional therapy of VVS treatment, treatments were given to all three groups for 8 weeks. And the negative conversion ratio of VVS in each group was observed. Hamilton Depression Scale (HAMD 24 items) and Hamilton Anxiety Scale (HAMA) were evaluated for the calculation of reductive rate. Treatment emergent symptoms scale (TESS) was used in the evaluation of adverse reactions of both medications during the treatment. In the 12-month follow-up after treatment, the recurrence rate of syncope was observed in each group. The results showed that compared with pretreatment, HAMD-24 and HAMA scores of group A and group B after treatment were significantly reduced (P < 0.05). Compared with group C, the heat-up tilt testing-negative rate, HAMD-24 and HAMA reductive rate of group A and group B after treatment were significantly increased (P < 0.05). Compared with group B, the negative rate, HAMD-24 and HAMA reductive rate of group A were more significant (P < 0.05). After treatment, scores for TESS of group A was significantly lower than group B (P< 0.05). In the 24-month follow-up, the recurrence rate of syncope of group A and group B was significantly lower than group C (P < 0.05); and group A was obviously better than group B (P < 0.05). It was concluded thatShugan Jieyu Capsules can be used in the treatment of VVS with mild-to-moderate depression and anxiety. Its effectiveness and safety may be better than Flupentixol and Melitracen Tablets.