舒肝解郁胶囊治疗抑郁症及超敏c反应蛋白水平的研究

发布时间：2018-05-23 22:35

本文选题：抑郁症 + 舒肝解郁胶囊　；参考：《新乡医学院》2017年硕士论文

【摘要】：背景近年来,抑郁症的患病率呈现出逐渐上升的趋势,且其致残率较高,严重影响患者的社会功能,已经成为严重的社会公共问题。由于抑郁症的病因不明、机制不清,导致药物起效缓慢、治疗率不高、容易复发,因此使得抑郁症的治疗的相关研究成为临床研究的热门话题。本文采用祖国医学的理论,对抑郁症的临床相及治疗进行了研究。目前有研究认为超敏c反应蛋白可能是抑郁症一个重要的指标,本文对其进行探讨。目的观察舒肝解郁胶囊与舍曲林片治疗抑郁症的疗效、不良反应,观察抑郁症患者治疗前后超敏c反应蛋白水平、认知功能的变化。方法本研究根据入组顺序随机分入组,纳入2016年1月至2016年12月于河南省精神卫生中心门诊或病房接受治疗的轻、中度抑郁症患者96例。将抑郁症患者分为2组:舒肝解郁组和舍曲林组(共同称为“患者组”),另设健康对照组40例。采用汉密顿抑郁量表(HAMD)评估患者组在治疗前及治疗第2、第4、第6周末的抑郁症状严重程度,应用韦氏智力测验(WAIS-RC)评估患者组在治疗前及治疗后第6周末的认知功能,采用副反应量表(TESS)观察患者组治疗后第2、第4、第6周末药物治疗的副反应,同时观察三组治疗前及患者组治疗后第2、第4、第6周末的hsCRP水平。数据统计采用SPSS19.0进行统计分析,包括描述统计、t检验和χ2检验、方差分析等。结果舒肝解郁组和舍曲林组在一般人口学资料如性别、年龄、受教育程度、婚姻状况等方面的无显著差异(P0.05),舒肝解郁组、舍曲林组与健康对照组在受教育水平方面差异显著(P0.001)。舒肝解郁组和舍曲林组在治疗前及治疗第2、4、6周末的HAMD评分多变量方差分析结果得到F值为37.33,P值小于0.01,说明4个治疗时段HAMD评分差异有显著统计学意义;同时得出治疗时间与治疗分组之间交互作用的F值为0.705,P值大于0.05,说明舒肝解郁组和舍曲林两组之间的HAMD评分无明显差异,无统计学意义(P0.05)。在治疗前的hsCRP水平方面,舒肝解郁组和舍曲林组均高于健康对照组,而舒肝解郁组和舍曲林组在治疗前后hsCRP水平无明显差异(P0.05)。在副反应发生率方面,舒肝解郁组(发生率为6.25%)低于舍曲林组(发生率为26%),有显著性差异(χ2=5.378,P0.05)。在认知功能方面,治疗前,三组在领悟、算术、数字广度、词汇、数字符号总数和正确数、填图分测验存在显著差异(P0.05);治疗后,舒肝解郁组在领悟、算术、词汇和数字符号分测验中的成绩高于治疗前,而相似性分测验的成绩低于治疗前,差异显著(t=-3.218,P=0.002;t=-2.314,P=0.038;t-=2.974,P=0.005;t=-3.151,P=0.037)。舍曲林组经治疗,其数字广度分测验、词汇分测验、数字符号分测验的成绩均优于治疗前,差异有统计学意义(t=-3.241,P=0.013;t=-3.241,P=0.013;t=-3.112,P=0.001)。结论舒肝解郁胶囊是一种既有效又安全的抗抑郁药。超敏c-反应蛋白与抑郁症的关系密切。抑郁症患者存在明显的认知功能障碍,舒肝解郁胶囊、舍曲林片治疗后认知功能有改善。
[Abstract]:In recent years, the prevalence of depression has been rising gradually, and its high disability rate, which seriously affects the social function of the patients, has become a serious social public problem. Because of the unknown cause of depression, the mechanism is not clear, the effect of the drug is slow, the rate of treatment is not high, and it is easy to recur, so it makes the treatment of depression. Research has become a hot topic in clinical research. This article uses the theory of Chinese medicine to study the clinical phase and treatment of depression. At present, it is considered that hypersensitive C reaction protein may be an important indicator of depression. Effect, adverse reaction, observation of the level of hypersensitive C reaction protein and the change of cognitive function before and after treatment in the patients with depression. Methods the study was randomly divided into groups according to the order of entry and included 96 mild, moderate depressive patients who were treated in the outpatient or ward of the mental health center of Henan province from January 2016 to December 2016. The patients were divided into 2 groups. The Shugan Jieyu group and sertraline group (commonly referred to as "patient group") and 40 healthy controls were set up by the Hamilton Depression Scale (HAMD) to assess the severity of depressive symptoms in the patients before and at the second, fourth, and sixth weekends of the treatment group. The Wechsler intelligence test (WAIS-RC) was used to assess the cognitive work of the patients before and after the sixth weekend of treatment. Yes, by using the side reaction scale (TESS) to observe the side effects of the second, fourth, and sixth weeks after treatment in the patient group. At the same time, the hsCRP levels of the three groups before and after the treatment were observed at second, fourth, and sixth weeks. The data were statistically analyzed by SPSS19.0, including the descriptive statistics, the t test, the chi 2 test and the variance analysis. There was no significant difference in general demographic data such as sex, age, education and marital status (P0.05), Shugan Jie Yu group, sertraline group and healthy control group (P0.001) in general demographic data such as sex, age, education, and marital status. The HAMD score of Shugan Jie Yu group and ralatin group before and after 2,4,6 weekend was more than that of Shugan Jie Yu group and sertraline group. The results of variable variance analysis showed that the F value was 37.33 and the P value was less than 0.01, indicating that the difference in HAMD score of the 4 periods of treatment was statistically significant. At the same time, the F value of the interaction between the treatment time and the treatment group was 0.705 and the P value was greater than 0.05, indicating that there was no significant difference in the HAMD score between the Shugan Jie Yu group and the sertraline two groups, and there was no statistical difference. P0.05. In the level of hsCRP before treatment, the Shugan Jie Yu group and sertraline group were all higher than those in the healthy control group, but there was no significant difference between the Shugan Jie Yu group and sertraline group before and after the treatment (P0.05). In the incidence of side effects, the group of Shugan Jie Yu (6.25%) was lower than the sertraline group (26%), and there were significant differences (the incidence of the group was 6.25%). Chi 2=5.378, P0.05). In cognitive function, before treatment, the three groups were in comprehension, arithmetic, digital breadth, vocabulary, total number of symbols and correct numbers, and there were significant differences (P0.05) in the mapping test. After treatment, the scores of the Shugan depressive group were higher than those before the treatment in the comprehension, arithmetic, vocabulary and digital sign test, while the results of the similarity test were low. Before treatment, the difference was significant (t=-3.218, P=0.002; t=-2.314, P=0.038; t-=2.974, P=0.005; t=-3.151, P=0.037). The sertraline group was treated with digital span test, vocabulary test, and digital symbol test. The difference was statistically significant (t=-3.241, P=0.013; t=-3.241, P=0.013; The Yu capsule is an effective and safe antidepressant. The hypersensitive c- reactive protein is closely related to depression. The patients with depression have obvious cognitive impairment, Shugan Jieyu capsule, and sertraline tablet after treatment.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.4

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