水木煎联合心理干预治疗围绝经期抑郁症的临床研究
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摘要
目的:观察水木煎联合心理干预治疗围绝经期抑郁症的疗效。方法:将90例围绝经期抑郁症患者随机分为西药组、中药组和中药联合心理干预组各30例,分别予不同治疗,比较治疗前后HAMD评分、改良Kupperman评分以及5-HT、FSH水平的变化。结果:治疗后3组患者HAMD评分、改良Kupperman评分均较治疗前降低,5-HT水平均较治疗前升高,差异均有统计学意义(P<0.05或P<0.01),中药联合心理干预组患者和中药组患者FSH水平较治疗前降低(P<0.01)。第4周末中药联合心理干预组患者HAMD评分明显低于西药组和中药组,5-HT水平明显高于西药组、中药组,差异均有统计学意义(P<0.05);中药组和西药组患者比较,差异均无统计学意义(P>0.05)。第4周末中药联合心理干预组、中药组患者Kupperman评分明显低于西药组患者,差异均有统计学意义(P<0.05);第8周末中药联合心理干预组患者Kupperman评分明显优于中药组(P<0.05)。第4周末中药联合心理干预组患者血清FSH水平低于西药组、中药组,中药组患者低于西药组,差异均有统计学意义(P<0.05);第8周末中药组患者FSH水平低于西药组(P<0.01)。结论:水木煎可有效降低围绝经期抑郁症患者HAMD评分,改善患者的抑郁程度,降低Kupperman评分,改善围绝经期综合征症状;联合心理干预后改善效果更加明显,说明起效机制可能与其明显提高血清5-HT水平和降低FSH水平有关。
Objective: To observe the efficacy of Shuimu decoction(水木煎) combined psychological intervention on perimenopausal depression. Methods: A total of 90 30 patients of perimenopausal depression were randomly into western medicine group, Chinese medicine group and Chinese medicine combined psychological intervention group, 30 cases in each group. Patients were treated by different medicine in three groups. The HAMD scale score, modified Kupperman scale score, serum 5-HT and FSH level were tested regularly. Results: After treatment, the HAMD scale score and modified Kupperman scale score decreased and the serum level of 5-HT increased in three groups(P<0.05 or P<0.01); The serum level of FSH decreased in Chinese medicine combined psychological intervention group and Chinese medicine group after treatment(P<0.01). At the 4 thweekend, the Chinese medicine combined psychological intervention group showed lower HAMD scores, while higher scale score and 5-HT level than western medicine group and Chinese medicine group(P<0.05), and the difference on those index between western medicine group and Chinese medicine group showed no statistical difference(P >0.05). At the 4 thweekend, the Chinese medicine combined psychological intervention group and Chinese medicine group showed lower modified Kupperman scale score than western medicine group(P<0.05). At the 8 th weekend, the Chinese medicine combined psychological intervention group showed lower modified Kupperman scale score than Chinese medicine group(P<0.05), and the difference was more significant(P<0.01). At the 4 th weekend, the Chinese medicine combined psychological intervention group showed lower serum FSH levels than western medicine group and Chinese medicine group, and Chinese medicine group showed lower serum FSH levels than western medicine group, with statistically significant difference(P <0.05). At the 8 thweekend, Chinese medicine group showed lower serum FSH levels than western medicine group(P<0.01). Conclusion: Shuimu decoction can effectively reduce the score of HAMD scale, relieve the degree of depression, reduce Kupperman scale score and improve the symptoms in patients with postmenopausal depression. Shuimu decoction combined psychological intervention showed more obvious effect, indicating that the mechanism might be related to the obvious improvement of serum 5-HT level and decreased FSH level.
Objective: To observe the efficacy of Shuimu decoction(水木煎) combined psychological intervention on perimenopausal depression. Methods: A total of 90 30 patients of perimenopausal depression were randomly into western medicine group, Chinese medicine group and Chinese medicine combined psychological intervention group, 30 cases in each group. Patients were treated by different medicine in three groups. The HAMD scale score, modified Kupperman scale score, serum 5-HT and FSH level were tested regularly. Results: After treatment, the HAMD scale score and modified Kupperman scale score decreased and the serum level of 5-HT increased in three groups(P<0.05 or P<0.01); The serum level of FSH decreased in Chinese medicine combined psychological intervention group and Chinese medicine group after treatment(P<0.01). At the 4 thweekend, the Chinese medicine combined psychological intervention group showed lower HAMD scores, while higher scale score and 5-HT level than western medicine group and Chinese medicine group(P<0.05), and the difference on those index between western medicine group and Chinese medicine group showed no statistical difference(P >0.05). At the 4 thweekend, the Chinese medicine combined psychological intervention group and Chinese medicine group showed lower modified Kupperman scale score than western medicine group(P<0.05). At the 8 th weekend, the Chinese medicine combined psychological intervention group showed lower modified Kupperman scale score than Chinese medicine group(P<0.05), and the difference was more significant(P<0.01). At the 4 th weekend, the Chinese medicine combined psychological intervention group showed lower serum FSH levels than western medicine group and Chinese medicine group, and Chinese medicine group showed lower serum FSH levels than western medicine group, with statistically significant difference(P <0.05). At the 8 thweekend, Chinese medicine group showed lower serum FSH levels than western medicine group(P<0.01). Conclusion: Shuimu decoction can effectively reduce the score of HAMD scale, relieve the degree of depression, reduce Kupperman scale score and improve the symptoms in patients with postmenopausal depression. Shuimu decoction combined psychological intervention showed more obvious effect, indicating that the mechanism might be related to the obvious improvement of serum 5-HT level and decreased FSH level.
引文
[1]丰有吉,沈铿.妇产科学[M].北京:人民卫生出版社,2007:18.
[2]沈渔邨.精神病学[M].4版.北京:人民卫生出版社,2007:544.
[3]曹泽毅.中华妇产科学[M].北京:人民卫生出版社,2000:2271-2281.
[4]中华医学会精神科学会,南京医科大学脑科医院.中国精神疾病分类与诊断标准[M].3版.南京:东南大学出版社,1995:32.
[5]张玉珍.中医妇科学[M].北京:中国中医药出版社,2002:168.
[6]Rajewska J,Rybakowski J K.Depression in premenopausal women:gonadal hormones and serotonergicsystem assessed by D-fenfluramine chanlle-nge test[J].Prog Neuropsychopharmacol Biol Psychiatry,2003,27(4):705-709.
[7]Schmidt R R.Biochemical.metabolic and vascular mechanisms in menop-ausal hot flushes[J].Fertil Steril,2003(70):332-337.
[8]关念红,黄兴兵,张晋碚,等.广泛性焦虑症和抑郁症儿茶酚胺血浓度的临床对照研究[J].中国神经精神疾病杂志,2003,29(2):88-90.
[9]钱洁,张捷,裴音,等.王氏五脏俞加膈俞治疗更年期抑郁症的临床观察[J].北京中医,2007,26(8):491-492.
[2]沈渔邨.精神病学[M].4版.北京:人民卫生出版社,2007:544.
[3]曹泽毅.中华妇产科学[M].北京:人民卫生出版社,2000:2271-2281.
[4]中华医学会精神科学会,南京医科大学脑科医院.中国精神疾病分类与诊断标准[M].3版.南京:东南大学出版社,1995:32.
[5]张玉珍.中医妇科学[M].北京:中国中医药出版社,2002:168.
[6]Rajewska J,Rybakowski J K.Depression in premenopausal women:gonadal hormones and serotonergicsystem assessed by D-fenfluramine chanlle-nge test[J].Prog Neuropsychopharmacol Biol Psychiatry,2003,27(4):705-709.
[7]Schmidt R R.Biochemical.metabolic and vascular mechanisms in menop-ausal hot flushes[J].Fertil Steril,2003(70):332-337.
[8]关念红,黄兴兵,张晋碚,等.广泛性焦虑症和抑郁症儿茶酚胺血浓度的临床对照研究[J].中国神经精神疾病杂志,2003,29(2):88-90.
[9]钱洁,张捷,裴音,等.王氏五脏俞加膈俞治疗更年期抑郁症的临床观察[J].北京中医,2007,26(8):491-492.