补肾调肝清心方对围绝经期抑郁症患者睡眠障碍的治疗机理探讨

Study of Bushen Tiaogan Qingxin Prescription in Treatment of Sleep Disorder in Climacteric Depression

目的探讨生殖内分泌激素与围绝经期抑郁症患者睡眠障碍的关系及补肾调肝消心方的治疗机理。方法60例患者按照随机、对照原则分为2组,中药组(30例)采用补肾调肝清心方治疗,另30例为激素替代疗法(HRT)组,治疗前及治疗后第12周进行汉密顿抑郁量表及睡眠障碍的评分,检测生殖内分泌激素雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)。结果中药组汉密顿抑郁量表减分率及睡眠障碍改善有效率优于HRT组(P<0.01)。治疗后2组血清E2升高(P<0.01),中药组FSH下降(P<0.01)、LH下降(P<0.05)、FSH/LH比值下降(P<0.01),HRT组FSH/LH比值下降(P<0.05)。结论生殖内分泌激素具有中枢神经系统调节作用,可直接或间接调节睡眠障碍。补肾调肝清心方通过益肾宁心、调和营卫、燮理阴阳综合调理睡眠障碍。

Objective To explore the relationship between genital endocrine hormones and sleep disorder in climacteric depression, and study the therapeutical functions of Bushen Tiaogan Qingxin Prescription. Methods Sixty patients were randomly divided into Bushen Tiaogan Qingxin prescription group （n =30） and HRT group （n =30）. The effects were appraised by both Hamilton depression rating scale （HAMD） and sleep disorder scores before and after the treatment of 12 weeks. The values of blood F2 ,FSH, LH were measured. Results Decreasing rate of HAMD and sleep disorder improving rate were significant in Bushen Tiaogan Qingxin prescription group than HRT group （P 〈0.01）. After the treatment, E2 rised in both groups （P〈0.01）. In Bushen Tiaogan Qingxin prescription group, FSH obviously descended （P〈0.01）, LH descended （P〈0.05）, FSH/LH descended （P〈0.01）. FSH/LH descended in HRT group too （P〈0.05）. Conclusion There is adjusted function to central nervous system with genital endocrine hormones, and they may improve sleep disorder directly or indirectly. Sleep disorder of climacteric depression was cured with Bushen Tiaogan Qingxin prescription effectively by comprehensive function of tong kidney and tranquilizing mind, regulating Ying and Wei, Yin and Yang.