益肾温胆汤联合舍曲林治疗肝郁痰阻型老年女性抑郁障碍的临床观察

Clinical Observation on The Effects of Tonifying Kidney and Clearing Gallbladder-heat Decoction Combined with Sertraline in Treating Senile Depression Patients with Liver Depression and Phlegm Obstruction

目的:探讨益肾温胆汤对老年抑郁症状的改善及对甲状腺激素水平的影响并分析两者的相关性。方法:57例老年抑郁患者随机分为2组,中药组29例给予益肾温胆汤联合舍曲林治疗,对照组28例给予舍曲林治疗,分别于基线及治疗后第2、4、6、8周末比较汉密尔顿抑郁量表(HAMD-24)评分及抑郁自评量表(SDS)评分,检测不同时点血清甲状腺激素(T4、T3、FT4、FT3、TSH)水平。结果:中药组在第2、4、6、8周HAMD及SDS减分率均优于对照组,中药组治疗后T3、T4、FT4有不同程度增高,TSH水平下降,与对照组比较差异有统计学意义;相关分析提示,HAMD与T3、T4、TSH无明显相关性,与FT4、FT3呈负相关。结论:益肾温胆汤联合舍曲林对患者抑郁状态的改善有增效作用,可显著降低HAMD及SDS评分,对异常甲状腺激素水平T3、T4、FT4、TSH有积极干预效果,优于单纯应用舍曲林。

Objective: To discuss the effect of tonifying kidney and clearing gallbladder-heat decoction in treating senile depression patients and change of serum thyroid hormone level. Meanwhile, to analyze the correlation between them. Methods: Fifty-seven senile depression patients were randomly divided into two groups: the traditional Chinese medicine group(29 cases with tonifying kidney and clearing gallbladder-heat decoction combined with sertraline) and the control group(28 cases with sertraline). Hamilton Depression scale(HAMD-24) score and self-rating depression scale(SDS) score were recorded at baseline and at the end of the 2 nd week, the 4 th week, the 6 th week, the 8 th week separately after treatment. Serum thyroid hormone T4, triiodothyronine T3, free thyroxine FT4, free triiodothyronine FT3, Thyroid Stimulating Hormone(TSH) were measured at the meantime.Results The HAMD and SDS reducing rate in traditional Chinese medicine group were better than the control group at the end of the 2 nd week, the 4 th week, the 6 th week, the 8 th week. After the treatment of traditional Chinese medicine, T3, T4 and FT4 increased in various degrees, TSH level decreased, and the differences ware statistically significant. The correlation analysis showed HAMD has no obvious correlation to T3, T4 and TSH, and has negative correlation to FT4 and FT3.Conclusions:Tonifying kidney and clearing gallbladder-heat decoction combined with sertraline has synergistic effect to improve the symptoms of depression patients. It can decrease the HAMD and SDS scores and has positive effects to regulate thyroid hormone levels of T3、T4、FT4 and TSH. The effect is better than using sertraline alone.