柴桂温胆定志汤联合帕罗西汀治疗抑郁症疗效和安全性评价
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摘要
目的探讨柴桂温胆定志汤联合帕罗西汀治疗抑郁症的疗效和安全性。方法将93例抑郁症患者随机分为对照组(单用帕罗西汀,46例)和研究组(联用柴桂温胆定志汤和帕罗西汀,47例),疗程均为4周。采用副反应量表(TESS)评定临床疗效和不良反应。结果研究组帕罗西汀用量、住院周期均明显优于对照组(P <0. 05);研究组临床总有效率为97. 87%,明显高于对照组的86. 96%(P <0. 05);重复测量方差分析显示,汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分时间与分组之间均存在交互作用(F=12. 406,10. 564,P=0. 000),治疗2,3,4周末,观察组HAMD和HAMA评分均明显低于对照组(P <0. 05);两组治疗第1,2,3,4周末TESS评分均无显著性差异(P> 0. 05),不良反应除恶心发生率对照组高于研究组外(P <0. 05),其余均无明显差异(P> 0. 05)。结论柴桂温胆定志汤联合帕罗西汀治疗抑郁症起效时间及疗效均优于单用帕罗西汀,不良反应相当。
Objective To investigate the efficacy and safety of Chaigui Wendan Dingzhi Decoction combined with paroxetine in the treatment of depression. Methods Totally 93 patients with depression were randomly divided into the control group( treated with paroxetine,46 cases) and the study group( Chaigui Wendan Dingzhi Decoction combined with paroxetine,47 cases). The course of treatment was 4 weeks. The clinical efficacy and adverse reactions were assessed by Treatment Emergent Symptom Scale( TESS). Results The dosages of paroxetine and hospitalization duration in the study group were significantly better than those in the control group( P < 0. 05). The total effective rate of the study group was 97. 87%,which was significantly higher than 86. 96% of the control group( P < 0. 05). Repeated measures analysis of variance showed that there was interaction between time and group in Hamilton Depression Scale( HAMD) score and Hamilton Anxiety Scale( HAMA) score( F = 12. 406,10. 564,P = 0. 000). After 2,3,4 weeks of treatment,the HAMD scores and HAMA score in the study group were significantly lower than those in the control group( P < 0. 05). After 1,2,3,4 weeks of treatment,there was no significant difference in TESS scores between the two groups( P > 0. 05). Except for the incidence of nausea in the control group was higher than that in the study group( P < 0. 05),there was no significant difference in the other adverse reactions between the two groups( P > 0. 05). Conclusion The initial effect time and efficacy of Chaigui Wendan Dingzhi Decoction combined with paroxetine in the treatment of depression were better than those of single-use paroxetine,and the adverse reactions of both are similar.
Objective To investigate the efficacy and safety of Chaigui Wendan Dingzhi Decoction combined with paroxetine in the treatment of depression. Methods Totally 93 patients with depression were randomly divided into the control group( treated with paroxetine,46 cases) and the study group( Chaigui Wendan Dingzhi Decoction combined with paroxetine,47 cases). The course of treatment was 4 weeks. The clinical efficacy and adverse reactions were assessed by Treatment Emergent Symptom Scale( TESS). Results The dosages of paroxetine and hospitalization duration in the study group were significantly better than those in the control group( P < 0. 05). The total effective rate of the study group was 97. 87%,which was significantly higher than 86. 96% of the control group( P < 0. 05). Repeated measures analysis of variance showed that there was interaction between time and group in Hamilton Depression Scale( HAMD) score and Hamilton Anxiety Scale( HAMA) score( F = 12. 406,10. 564,P = 0. 000). After 2,3,4 weeks of treatment,the HAMD scores and HAMA score in the study group were significantly lower than those in the control group( P < 0. 05). After 1,2,3,4 weeks of treatment,there was no significant difference in TESS scores between the two groups( P > 0. 05). Except for the incidence of nausea in the control group was higher than that in the study group( P < 0. 05),there was no significant difference in the other adverse reactions between the two groups( P > 0. 05). Conclusion The initial effect time and efficacy of Chaigui Wendan Dingzhi Decoction combined with paroxetine in the treatment of depression were better than those of single-use paroxetine,and the adverse reactions of both are similar.
引文
[1]许乐思,陈雨,王梦莎,等.抑郁症的中医临床辨证规律研究[J].湖北中医药大学学报,2017,19(3):37.
[2]张潇,田俊生,刘欢,等.抗抑郁中药新药研发进展[J].中国中药杂志,2017,42(1):29-33
[3]呼亚玲.巴戟天寡糖胶囊治疗轻中度抑郁症急性发作期的临床研究[J].中西医结合心脑血管病杂志,2018,16(7):970-992.
[4]郭玉梅,李海洲.解郁安神定志汤合用帕罗西汀治疗心理抑郁症的临床效果[J].中药药理与临床,2015,31(4):264-266.
[5]王东明,刘琳琳,孙平,等.小柴胡汤改善抑郁症状及相关神经递质与神经营养因子分析[J].国际精神病学杂志,2016,43(1):100.
[6]陈明伦.柴桂温胆定志汤治疗精神抑郁症理论研究与临床观察[D].北京:北京中医药大学,2007.
[7]季建林.抗抑郁药物治疗的起效与疗效评价[J].世界临床药物,2012,7(7):385-387.
[8]朱咏梅,尹斌.抗抑郁药物的相关研究及其临床疗效[J].临床合理用药,2018,11(3c):178-179.
[9]王小党,何丽云,刘艳骄.抗抑郁药物治疗抑郁症的研究概况[J].世界最新医学信息文摘,2018,18(6):50-53.
[10]赵智勇,耿慧春,姚兵,等,柴胡桂枝汤抗抑郁作用的实验研究[J].中医药信息,2006,23(3):50-51.
[11]王建婷,王上,刘松林,等.基于整合药理学平台的柴胡-黄芩药对抗抑郁的分子机制研究[J].中国中药杂志,2018,43(7):1323-1330.
[12]王默然,付雨农,崔志伟,等.温胆汤对帕金森病模型大鼠抑郁样行为及脑内单胺类神经递质的影响[J].西安交通大学学报(医学版),2017,38(4):606-610.
[13]武丽,张丽萍,叶庆莲,等.加减温胆汤对抑郁模型大鼠行为学和血浆生长抑素含量的影响[J].中国临床康复,2005,9(8):114-115.
[14]孙丰润,侯佃臻,张循格,等.安神定志丸安神作用研究[J].中国药业,2005,14(4):31-32.
[15]高舜天,刘仙,何恽晔.间断服用柴桂温胆定志汤治疗轻中度抑郁症疗效持续时间观察[J].中医临床研究,2017,9(36):1-3.
[16]陈建,王贺,陈志展,等.柴桂温胆定志汤对抑郁模型大鼠海马神经递质的影响[J].福建中医药大学学报,2010,20(5):10-11.
[17]成翔,张蕾,姚莉红,等.慢性应激抑郁状态对大鼠海马神经元再生的影响[J].神经解剖学杂志,2013,29(4):431-434.
[18]陈建,王贺,林久茂,等.柴桂温胆定志汤对抑郁模型大鼠海马BDNF和TrκB的影响[J].长春中医药大学学报,2010,26(5):643-644.
[2]张潇,田俊生,刘欢,等.抗抑郁中药新药研发进展[J].中国中药杂志,2017,42(1):29-33
[3]呼亚玲.巴戟天寡糖胶囊治疗轻中度抑郁症急性发作期的临床研究[J].中西医结合心脑血管病杂志,2018,16(7):970-992.
[4]郭玉梅,李海洲.解郁安神定志汤合用帕罗西汀治疗心理抑郁症的临床效果[J].中药药理与临床,2015,31(4):264-266.
[5]王东明,刘琳琳,孙平,等.小柴胡汤改善抑郁症状及相关神经递质与神经营养因子分析[J].国际精神病学杂志,2016,43(1):100.
[6]陈明伦.柴桂温胆定志汤治疗精神抑郁症理论研究与临床观察[D].北京:北京中医药大学,2007.
[7]季建林.抗抑郁药物治疗的起效与疗效评价[J].世界临床药物,2012,7(7):385-387.
[8]朱咏梅,尹斌.抗抑郁药物的相关研究及其临床疗效[J].临床合理用药,2018,11(3c):178-179.
[9]王小党,何丽云,刘艳骄.抗抑郁药物治疗抑郁症的研究概况[J].世界最新医学信息文摘,2018,18(6):50-53.
[10]赵智勇,耿慧春,姚兵,等,柴胡桂枝汤抗抑郁作用的实验研究[J].中医药信息,2006,23(3):50-51.
[11]王建婷,王上,刘松林,等.基于整合药理学平台的柴胡-黄芩药对抗抑郁的分子机制研究[J].中国中药杂志,2018,43(7):1323-1330.
[12]王默然,付雨农,崔志伟,等.温胆汤对帕金森病模型大鼠抑郁样行为及脑内单胺类神经递质的影响[J].西安交通大学学报(医学版),2017,38(4):606-610.
[13]武丽,张丽萍,叶庆莲,等.加减温胆汤对抑郁模型大鼠行为学和血浆生长抑素含量的影响[J].中国临床康复,2005,9(8):114-115.
[14]孙丰润,侯佃臻,张循格,等.安神定志丸安神作用研究[J].中国药业,2005,14(4):31-32.
[15]高舜天,刘仙,何恽晔.间断服用柴桂温胆定志汤治疗轻中度抑郁症疗效持续时间观察[J].中医临床研究,2017,9(36):1-3.
[16]陈建,王贺,陈志展,等.柴桂温胆定志汤对抑郁模型大鼠海马神经递质的影响[J].福建中医药大学学报,2010,20(5):10-11.
[17]成翔,张蕾,姚莉红,等.慢性应激抑郁状态对大鼠海马神经元再生的影响[J].神经解剖学杂志,2013,29(4):431-434.
[18]陈建,王贺,林久茂,等.柴桂温胆定志汤对抑郁模型大鼠海马BDNF和TrκB的影响[J].长春中医药大学学报,2010,26(5):643-644.