平心忘忧胶囊治疗抑郁症临床研究
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摘要
目的:探讨平心忘忧胶囊治疗抑郁症的临床疗效及其作用机制。方法:选取2014年1月至2016年12月在本院胡思荣工作室就诊的抑郁症患者209例,随机分为西医组69例、中医组70例和中西医组70例。西医组给予氟西汀胶囊口服治疗,中医组给予平心忘忧胶囊治疗,中西医组给予平心忘忧胶囊联合氟西汀胶囊治疗。结果:中医组有效率87.14%,西医组有效率66.67%,中西医组有效率92.85%,三组有效率比较,中药组与中西医组优于西医组(P<0.05),差异有统计学意义,中西医组优于中药组,但差异无统计学意义(P>0.05);中医组、中西医组主要证候评分、次要证候评分优于西医组,差异有统计学意义(P<0.05);中医组、中西医组多巴胺、5-羟色胺(5-hydroxy trytamin,5-HT)、去甲肾上腺素水平优于西医组,差异有统计学意义(P<0.05)。结论:"痰火"因素与体内5-HT激素水平呈负相关,平心忘忧胶囊治疗抑郁症疗效显著,可能是通过清心豁痰、疏肝利胆作用,改变体内5-HT水平,从而较好的改善临床症状。
Objective: To observe the clinical curative effect and its mechanism of Pingxin Wangyou Capsules( PXWYC) on depression. Methods: Two hundred and nine cases of depression were selected from January 2014 to December 2016 in Hu Si-rong's studio in our hospital. They were randomly divided into the Western medicine group with 69 cases,the TCM group with 70 cases and the group of integrated Chinese and Western medicine with 70 cases. The ones in the Western medicine group were treated with fluoxetine capsules for oral administration,the ones in the TCM group were treated with PXWYC. The ones in the group of integrated Chinese and Western medicine were treated with PXWYC combined with fluoxetine capsules. Results: The effective rate of the TCM group was 87. 14%,that of the Western medicine group was 66. 67%,and that of the group of integrated Chinese and Western medicine was 92. 85%. The TCM group and the group of integrated Chinese and Western medicine were superior to the Western medicine group( P < 0. 05),the difference was statistically significant. The group of integrated Chinese and Western medicine was superior to the TCM group,but the difference was not statistically significant( P > 0. 05). The main syndromes scores and the scores of secondary syndrome of the TCM group and the group of integrated Chinese and Western medicine were better than those of Western medicine group,and all the differences were statistically significant( P < 0. 05). The levels of dopamine,5-serotonin and norepinephrine of the TCM group and the group of integrated Chinese and Western medicine were better than those of Western medicine group,and all the differences were statistically significant( P < 0. 05). Conclusion: The " phlegmfire" factor is negatively related to the level of 5-HT hormone in the body. The effect of PXWYC in the treatment of depression is significant. It may be to improve the 5-HT level in the body and enhance the clinical symptoms by clearing away fire in the heart,removing phlegm dispersing the liver and promoting the gallbladder.
Objective: To observe the clinical curative effect and its mechanism of Pingxin Wangyou Capsules( PXWYC) on depression. Methods: Two hundred and nine cases of depression were selected from January 2014 to December 2016 in Hu Si-rong's studio in our hospital. They were randomly divided into the Western medicine group with 69 cases,the TCM group with 70 cases and the group of integrated Chinese and Western medicine with 70 cases. The ones in the Western medicine group were treated with fluoxetine capsules for oral administration,the ones in the TCM group were treated with PXWYC. The ones in the group of integrated Chinese and Western medicine were treated with PXWYC combined with fluoxetine capsules. Results: The effective rate of the TCM group was 87. 14%,that of the Western medicine group was 66. 67%,and that of the group of integrated Chinese and Western medicine was 92. 85%. The TCM group and the group of integrated Chinese and Western medicine were superior to the Western medicine group( P < 0. 05),the difference was statistically significant. The group of integrated Chinese and Western medicine was superior to the TCM group,but the difference was not statistically significant( P > 0. 05). The main syndromes scores and the scores of secondary syndrome of the TCM group and the group of integrated Chinese and Western medicine were better than those of Western medicine group,and all the differences were statistically significant( P < 0. 05). The levels of dopamine,5-serotonin and norepinephrine of the TCM group and the group of integrated Chinese and Western medicine were better than those of Western medicine group,and all the differences were statistically significant( P < 0. 05). Conclusion: The " phlegmfire" factor is negatively related to the level of 5-HT hormone in the body. The effect of PXWYC in the treatment of depression is significant. It may be to improve the 5-HT level in the body and enhance the clinical symptoms by clearing away fire in the heart,removing phlegm dispersing the liver and promoting the gallbladder.
引文
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[9]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社出版,1994:20.
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[11]ANGELELLI P,PAOLUCEI S,BIVONA U,et al.Development of neuropsychiatric symptoms in poststroke patients:a cross-sectional study[J].Acta Psyehiatr Seand,2004,110(1):55-63.
[12]高霞,高磊,马钊,等.慢性期脑卒中患者抑郁状态的发生率及相关因素[J].中国康复医学杂志,2012,4(27):339-343.
[13]王纯,楚艳民,张亚林,等.汉密尔顿焦虑量表的因素结构研究[J].临床精神学杂志,2011,5(21):299-301.
[14]陈微,赵树华.百合地黄汤治疗脑卒中后抑郁症的疗效观察[J].中国老年学杂志,2004,24(5):417.
[15]文伟.抑郁药的药理及临床应用[J].中国新药与临床杂志,1998,17(2):105.
[2]瞿伟,谷珊珊.抑郁症治疗研究新进展[J].第三军医大学学报,2014,36(11):1113-1117.
[3]徐春燕.中药复方治疗抑郁症的临床研究[D].北京:北京中医药大学,2013.
[4]李林艳,徐建.抑郁症治疗进展[J].河南中医,2012,32(12):1720-1722.
[5]张明园.精神科评定量表手册[M].长沙:湖南科技出版社,1993:198-204.
[6]中华医学会神经精神科委员会.躁狂抑郁症临床工作诊断标准[J].中西医结合杂志,1988,8(2):127.
[7]陈文恺,周玲,梅晓云,等.571例抑郁症中医证候学临床流行病学调查[J].浙江中医杂志,2007,42(5):262-263.
[8]赵燕,王天芳.抑郁症中医证候及证候要素分布特点的文献研究[J].中医杂志,2006,47(9):691-692.
[9]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社出版,1994:20.
[10]中华医学会精神病分会.中国精神障碍分类与诊断标准[S].济南:山东科学技术出版社,2001:87-89.
[11]ANGELELLI P,PAOLUCEI S,BIVONA U,et al.Development of neuropsychiatric symptoms in poststroke patients:a cross-sectional study[J].Acta Psyehiatr Seand,2004,110(1):55-63.
[12]高霞,高磊,马钊,等.慢性期脑卒中患者抑郁状态的发生率及相关因素[J].中国康复医学杂志,2012,4(27):339-343.
[13]王纯,楚艳民,张亚林,等.汉密尔顿焦虑量表的因素结构研究[J].临床精神学杂志,2011,5(21):299-301.
[14]陈微,赵树华.百合地黄汤治疗脑卒中后抑郁症的疗效观察[J].中国老年学杂志,2004,24(5):417.
[15]文伟.抑郁药的药理及临床应用[J].中国新药与临床杂志,1998,17(2):105.