解郁汤联合氟西汀治疗肝郁脾虚型抑郁症30例临床研究

Clinical trial of Jieyutang combined with Fluoxetine in the treatment of depression

目的观察解郁汤联合氟西汀治疗肝郁脾虚型抑郁症的临床疗效。方法将60例肝郁脾虚型抑郁症患者随机分为2组,治疗组30例予解郁汤合氟西汀治疗,对照组30例单纯氟西汀治疗。2组均6周为1个疗程,1个疗程后统计临床疗效,并以副反应量表(TESS)记录患者治疗过程中的不良反应。观察治疗前及治疗第2、4、6周末汉密尔顿抑郁量表(HAMD)总评分及中医主要症状积分变化情况。结果治疗组总有效率为90.00%,对照组总有效率为76.67%,2组比较差异有统计学意义(P<0.05),治疗组疗效优于对照组;2组治疗第2、4、6周HAMD评分与本组治疗前比较差异均有统计学意义(P<0.05,P<0.01);2组治疗第4、6周HAMD评分比较差异均有统计学意义(P<0.05,P<0.01),治疗组优于对照组。2组治疗第2、4、6周后中医主要症状积分均较治疗前明显降低(P<0.05,P<0.01);与对照组相比,治疗组对时有太息、胁肋胀痛症状治疗效果更好(P<0.01),对于兴趣索然、精神萎靡2组疗效相当(P>0.05)。结论解郁汤联合氟西汀治疗抑郁症肝郁脾虚型疗效确切,且副反应小,安全性好。

Objective To observe the effect of Jieyutang combined with Fluoxetine in the treatment of depression belonging to liver-qi stagnation and spleen-deficiency type.Methods ：With a randomized controlled trial principle,60 patients with mild or moderate depression of liver-qi stagnation and spleen-deficiency type were randomly divided into two groups.The treatment group（n=30） was given Jieyutang combined with Fluoxetine orally for 6 weeks,and the control group was given Fluoxetine capsules for 6 weeks.Efficacy was assessed with the Hamilton Rating Scale for Depression（HAMD）,and the scale for symptoms of TCM（Traditional Chinese Medicine） set by the researchers.Treatment Emergent Symptom Scale（TESS） was used to assess for possible side effects.The total score and factor scores from both HAMD and the scale for symptoms of TCM were counted before treatment,at the end of 2,4 and 6 weeks＇ treatment.Results The total effective rate in treatment group（90.00%） was higher than that in control group（76.67%,P0.05）.There were significant differences between before and after treatment on HAMD score at the end of 2-6 weeks＇ treatment in two groups（P0.05,P0.01）.There were significant differences between two groups on HAMD score at the end of 4-6 weeks＇ treatment（P0.05,P0.01）.The scores of traditional Chinese medicine main symptoms at the end of 4-6 weeks＇ treatment were obviously decreased as compared with those before treatment in two groups（P0.05,P0.01）.There were differenced between two groups on improvement of some symptoms（sighing,distending pain in hypochondrium） after treatment（P0.01）.Conclusion Jieyutang combined with Fluoxetine was definite,small adverse reaction and safe in the treatment of depression belonging to liver-qi stagnation and spleen-deficiency type.Integrated traditional Chinese medicine and western medicine therapy has certain advantages in the treatment of depression.