清心滋肾汤加味联合文拉法辛治疗围绝经期抑郁症的临床疗效观察

发布时间：2018-08-24 08:33

【摘要】：目的:观察清心滋肾汤加味联合文拉法辛缓释片对心肾不交肝郁型围绝经期抑郁症的临床疗效。方法:临床收集60例符合诊断标准、纳入标准的围绝经期抑郁症患者,随机分为2组,各30例,对照组予盐酸文拉法辛缓释片,治疗组在对照组的基础上予清心滋肾汤加味。两者疗程均为8周。观察并比较两组患者治疗前后血清雌二醇(E2)、促卵泡生成素(FSH)水平,血小板5-轻色胺(5-HT)浓度及17项汉密尔顿抑郁量表(HAMD-17)、中医证候量表、改良Kupperman评分表评分变化情况。此次研究以HAMD-17抑郁量表作为疾病疗效评价,中医症候量表评分作为主要疗效指标,改良Kupperman评分表评分作为次要疗效指标。结果:①两组围绝经期抑郁症患者治疗后三组评分均较用药前有明显的降低,差异显著(P0.05);中药联合抗抑郁药组与单用抑郁药组疗效比较,前者明显优于后者(P0.05)。②治疗后两组血清E2水平均较治疗前明显升高,治疗组较对照组显著(P0.05);两组血清FSH水平相比治疗前均有所下降,治疗组下降更显著(P0.05)。③治疗后两组患者血小板5-HT浓度均较用药前明显增加(P0.05),治疗组血小板5-HT浓度增加较对照组明显,差异有统计学意义(P0.05)。④治疗后,治疗组、对照组总有效率分别为93.33%、73.33%,中药联合抗抑郁药组优于单用抗抑郁药组(P0.05)。⑤中药联合抗抑郁药、单用抗抑郁药组不良反应发生率分别为23%、50%,差异有统计学意义(P0.05)。结论:清心滋肾汤加味治疗心肾不交肝郁型围绝经期抑郁症临床有效;对围绝经期抑郁症患者生殖内分泌水平及单胺类神经递质含量有一定调节作用;清心滋肾汤加味与抗抑郁药盐酸文法拉辛缓释片联合应用能够提高其疗效且能预防和减少其不良反应的发生,亦能有效缓解围绝经期相关不适症状。
[Abstract]:Objective: to observe the clinical effect of Qingxin Zishen decoction combined with venlafaxine sustained-release tablet in treating peri-menopausal depression with heart and kidney non-liver-depression. Methods: sixty patients with peri-menopausal depression who met the diagnostic criteria were randomly divided into two groups, 30 patients in each group. The control group was treated with venlafaxine hydrochloride sustained release tablets, and the treatment group was treated with Qingxin Zishen decoction on the basis of the control group. Both courses of treatment were 8 weeks. The changes of serum estradiol (E2), follicle stimulating hormone (FSH), platelet concentration of 5-light tryptamine (5-HT), 17 items of Hamilton Depression scale (HAMD-17), TCM Syndrome scale and modified Kupperman scale were observed and compared before and after treatment. In this study, the HAMD-17 Depression scale was used as the evaluation of the curative effect of the disease, the TCM symptom scale as the main curative effect index, and the modified Kupperman scale as the secondary curative effect index. Results the scores of the three groups in the two groups were significantly lower than those before treatment (P0.05), and the curative effect of the traditional Chinese medicine combined with antidepressant group was higher than that of the single antidepressant group. The serum E2 level in the former group was significantly higher than that in the control group after treatment (P0.05), and the serum FSH level in the treatment group was significantly lower than that in the control group (P0.05). The concentration of platelet 5-HT in the treatment group was significantly higher than that in the control group (P0.05) after treatment (P0.05). The platelet 5-HT concentration in the treatment group was significantly higher than that in the control group (P0.05), and the difference was statistically significant (P0.05) after treatment, the concentration of platelet 5-HT in the treatment group was significantly higher than that in the control group (P0.05). The total effective rates of the control group were 93.33 and 73.33, respectively. The Chinese medicine combined with antidepressant group was better than the single antidepressant group (P0.05). The incidence of adverse reactions in the single antidepressant group was 2350. The difference was statistically significant (P0.05). Conclusion: Qingxinzishen decoction is effective in treating depression in peri-menopausal period of Xinshen non-liver-depression type and has certain regulating effect on reproductive endocrine level and monoamine neurotransmitter content in patients with peri-menopausal depression. The combination of Qingxin Zishen decoction and antidepressant Grammaraxine Hydrochloride sustained release tablets can improve its curative effect, prevent and reduce the occurrence of adverse reactions, and relieve the symptoms related to menopause effectively.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.4

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