解郁活血汤治疗2型糖尿病伴抑郁症临床观察

Clinical Observation on Jieyu Huoxue Decoction in Treating Type 2 Diabetes Mellitus Coexisting Major Depression

目的:观察解郁活血汤治疗2型糖尿病伴抑郁症的临床疗效。方法:将伴有抑郁症的2型糖尿病患者67例,随机分为治疗组与对照组,在糖尿病常规治疗基础上,对照组予谷维素20mg口服,治疗组在对照组基础上加用解郁活血汤治疗。疗程8周,采用汉密顿抑郁量表(HAMD)定期进行疗效评定,并观察治疗前后血糖、糖化血红蛋白(HbA1c)的变化。结果:治疗组痊愈2例,显效9例,有效17例,无效7例,总有效率80.0%;对照组痊愈1例,显效6例,有效13例,无效12例,总有效率62.5%。2组比较,差异有显著性意义(P<0.05),治疗组疗效优于对照组。HAMD评分治疗组治疗后4周和8周与治疗前比较,差异有显著性或非常显著性意义(P<0.05或P<0.01);对照组治疗后8周与治疗前比较,差异有显著性意义(P<0.05);2组治疗8周后比较,差异有显著性意义(P<0.05)。治疗后2组空腹血糖(FBG)、餐后2小时血糖(P2hBG)及HbA1c均较治疗前有改善,差异均有显著性意义(P<0.05);而治疗组改善优于对照组,差异也有显著性意义(P<0.05)。结论:解郁活血汤可有效改善2型糖尿病伴抑郁症患者抑郁症状,同时也间接地改善糖尿病患者的平均血糖水平,临床疗效满意。

Objective：To observe the efficacy of Jieyu Huoxue Decoction in treating type 2 diabetes mellitus（T2DM）coexisting major depression. Methods.. Sixty-seven patients of T2 DM coexisting major depression were randomly divided into two groups. On the basis of the conventional treatment with hypoglycemic agents, both groups were given orat use of oryzanol 20mg per day, and the treatment group was given Jieyu Huoxue Decoction additionally. The treatment course lasted 8 weeks. Hamilton rating scale for depression （HAMD）was used for the evaluation of therapeutic effect, and the changes of blood glucose and glycosylated hemoglobin（HbA1c）were also examined. Results： After treatment, 2 patients were cured, 9 markedly effective, 17 effective, 7 ineffective in the treatment group, the total effective rate being 80%. In the control group, one patient was cured, 6 markedly effective, 13 effective, 12 ineffective, the total effective rate being 62.5%. There was significant difference of total effective rate between the two groups （P 〈 0.05）, and the treatment group was superior to the control group. In the treatment group, HAMD scores after 4-week or 8-week treatment differed from those before treatment （P 〈 0.05 or P 〈 0.01）. In the control group, HAMD scores after 8-week treatment differed from those before treatment （P 〈 0.05）. The difference of HAMD scores after 8-week treatment was significant between two groups （P 〈 0.05）. The levels of fasting blood glucose（FBG）, postprandial 2-hour blood glucose（P2hBG）and HbAlc were decreased in both groups （P 〈 0.05 compared with those before treatment）, and the decrease in the treatment group was superior to that in the control group（P 〈 0.05）. Conclusion： Jieyu Huoxue Decoction exerts certain therapeutic effect by relieving the depressive symptoms of T2 DM and by indirectly decreasing the average blood glucose levels.