补肾调肝清心方治疗更年期抑郁症的临床研究

Study on Treatment of Climacteric Depression with Bushen Tiaogan Qingxin Recipe

目的通过临床观察补肾调肝清心方对更年期抑郁症患者HAMD抑郁量表评分、单胺类神经递质及内分泌功能的影响 ,探讨其疗效机理。方法按照随机、对照原则分为两组 ,中药组 (采用补肾调肝清心方 ) 2 5例与激素替代疗法 (HRT)组 15例 ,治疗前后分别对两组进行HAMD抑郁量表评分 ,检测血浆 5 羟色胺 ( 5 HT)、去甲肾上腺素 (NE) ,血清E2 、FSH、LH及B超测定子宫内膜厚度。结果中药组治疗总有效率为 87 2 %,HRT组为 67 3%。两组治疗后HAMD量表总分比较差异有显著性 (P <0 0 5 )。治疗后中药组血浆 5 HT下降 (P <0 0 1) ,NE升高 (P <0 0 5 ) ,5 HT/NE比值下降 (P <0 0 1) ;两组血清E2 升高 (P <0 0 1) ;中药组FSH下降 (P <0 0 1)、LH下降 (P <0 0 5 ) ,FSH/LH比值下降 (P <0 0 1) ;HRT组FSH/LH比值下降 (P <0 0 5 )。B超测定子宫内膜厚度 ,HRT组治疗后升高 (P <0 0 5 )。结论补肾调肝清心方治疗更年期抑郁症 ,其机制可能与以下作用有关 :( 1)调节单胺类神经递质的合成与释放 ;( 2 )调节生殖内分泌功能 ;( 3)

Objective To observe the effects of Bushen Tiaogan Qingxin recipe (BTQR) on Hamilton rating scale for depression (HAMD), monoamine meurotransmitter and endocrinal function in patients with climacteric depression, and to explore its mechanism. Methods Patients were randomly divided into two groups, the 25 patients in the treated group treated with BTQR and 15 patients in the control group treated with hormone replacement therapy (HRT). The HAMD scoring, levels of 5 HT, NE in plasma, serum estradiol (E 2), follicule stimulating hormone (FSH), luteinizing hormone (LH) were determined before and after treatment, and the thickness of endometrium was measured by B Doppler ultrasonographic technique.Results The total effective rate, evaluated by the HAMD score reducing rate, in the treated group was 87.2%, and in the control group was 67 3%, showing significant difference (P<0.05). After treatment, 5 HT decreased (P<0.01), NE increased (P<0.05) and 5 HT/NE ratio lowered (P<0.01) in the treated group; E 2 increased in both groups; FSH, LH and FSH/LH ratio decreased in the treated group (P<0.05 or P<0.01), FSH/LH ratio decreased in the control group (P<0.05). The thickness of endometrium increased in the control group after treatment (P<0 05). Conclusion The mechanism of BTQR in treating climacteric depression might be related with its actions in: (1) To regulate the synthesis and release of monoamine neurotransmitter; (2) To adjust reproductive endocrine function; (3) To coordinate the neuroendocrinal function.