郁乐冲剂对抑郁症患者认知功能的影响研究

The Effect of Yule Powder Preparation for Infusion on Cognition Ability of Depression Patient

目的:研究郁乐冲剂治疗抑郁症认知功能障碍的药理机制及临床疗效。方法:收集符合诊断标准的抑郁症患者60例,随机分为郁乐冲剂组、百忧解组2组,健康对照组选取深圳市中医院健康职工、在院研究生、实习生,共20名。疗程为84d。观察指标包括:治疗前后神经病理学测验方法l7项汉密顿抑郁量表(HAMD)、治疗前后神经心理学测验方法威斯康星卡片分类测验(WCST)、治疗前后血浆皮质醇浓度测定。结果:郁乐冲剂组有效率为89.66%,百忧解组为88.46%,两组相比无显著性差异(P>0.05);治疗后郁乐冲剂组与百忧解组患者HRSD总分及各因子分均下降,差异有统计学意义(P<0.05),在各因子分所代表的靶症状群改善上,郁乐冲剂与百忧解表现略有不同:其中焦虑/躯体化、睡眠障碍两个因子分两者改善程度接近(P>0.05),与健康对照组得分差异无统计学意义(P>0.05),认知障碍因子分和迟滞因子分改善上,两者改善程度接近(P>0.05),得分仍低于健康对照组,差异有统计学意义(P<0.05);治疗后郁乐冲剂组与百忧解组患者WCST因子分正确数、分类数提高,错误数、持续错误数、随即错误数均下降,差异有统计学意义(P<0.05),治疗后郁乐冲剂组与百忧解组五个因子的改善程度接近,无明显变化(P>0.05),但与健康对照组得分差异有统计学意义(P<0.05);治疗后郁乐冲剂组与百忧解组患者血清皮质醇均显著下降,差异有统计学意义(P<0.05),治疗后郁乐冲剂组与百忧解组血清皮质醇的改善程度接近,无明显变化(P>0.05),与健康对照组皮质醇差异有统计学意义(P<0.05);治疗前抑郁症患者皮质醇与WCST错误数、持续错误数、随机错误数呈正相关,有统计学意义(P<0.05);与正确数、分类数呈负相关,有显著统计学意义(P<0.05)。结论:表明郁乐冲剂及百忧解均能有效治疗抑郁症认知功能障碍,抑郁症患者治疗前后的血浆皮质醇水平改变,提示郁乐冲剂与百忧解在治疗抑郁症认知功能障碍的药理机制及途径上可能相近,均能够降低血清皮质醇水平。

Objective：To research pharmaco-mechanism and clinical curative effect of depression cognitive dysfunction treating with Yule medicinal instant granules.Methods：60 cases agreed diagnostic code were collected,were randomly divided into Yule group and Prozac group.Healthy employees,postgraduates and trainees（20 people） of Shenzhen Municipal Hospital of Chinese Medicine in heathy control groups,12 weeks is one course of treatment.Observation index include：Pretherapy and post-treatment neuropathology test method 17 hamilton depression rating scale（HAMD）,pretherapy and post-treatment neuropsychological test Wisconsin Card Sorting Test（WCST）,pretherapy and post-treatment blood plasma cortisol concentration measurement .Results：Total effect rate is 89.66% in Yule group,88.46% in Prozac group,two groups were compared to having no significant difference（P〈0.05）,posttreatment HRSD total score and quaque factor score all descend in two groups,difference have statistical significance（P〈0.05）,on quaque factor score rep.target symptoms amelioration,Yule and Prozac have difference,amelioration degree of anxiety / somatization and sleep disorders is near（P〈0.05）,difference is not statistically significant with heathy control group ,on cognitive disorder factor score and lag factor score amelioration ,amelioration degree is near（P〈0.05）,score is lower than heathy contro group,difference is statistically significant,post-treatment WSCT factor score correct number,categorization number boost,errors number,continuing errors number immediately errors number all low ,difference have statistical significance（P〈0.05）,post-treatment amelioration degree of five factor is near,having no marked change（P〈0.05）,difference have statistical significance（P〈0.05）with heathy control group,post-treatment blood serum cortisol all patency low in two groups,difference have statistical significance（P〈0.05）,amelioration degree of blood serum cortisol in two groups are near,having no marked change（P〈0.05）,difference have statistical significance（P〈0.05）with heathy control group,pretherapy depression cortisolwith CST errors number,continuing errors number and random errors number have positive correlation,have statistical significance（P〈0.05）,with correct number and categorization number have negative correlation,have patency statistical significance（P〈0.05）.Conclusion：The research indicate,Yule medicinal instant granules and Prozac all can treat depression cognitive dysfunction effectively,pretherapy and post-treatment blood serum cortisol level of depression alteration,hinting pharmaco-mechanism and path of Yule and Prozac on depression cognitive dysfunction may be near,all can low blood serum cortisol level.