中药对肾虚肝郁型女性抑郁症患者性激素的干预作用

Changes of sex hormone in female depression patients of kidney deficiency and liver depression and the intervention traditional Chinese medicine

目的探讨肾虚肝郁型女性抑郁症患者性激素水平变化及中药的干预情况。方法选择2007年3月至2011年3月符合CCMD-3、ICD-10中抑郁发作诊断标准和中医辨证标准的120例患者，按年龄病情等因素运用分层随机分组法分为两组各60例。治疗组口服具有补。肾疏肝功效的中药治疗，对照组口服帕罗西汀，两组患者均治疗12周。同时另设健康组60例，于治疗结束时进行HAMD评分和中医症状评分比较，观察血清雌二醇（E2）、孕酮（P）、催乳素（PRL）的变化。结果治疗后，治疗组E2水平升高、PRL水平下降，与同组治疗前比较，差异有统计学意义[E2冶疗前=（103．6±28．24）pmol／L，E2治疗后=（167．7±30．46）pmol／L：PRL治疗前=（32．5±7．61）μg／L，PRL{古口目：（15．3±5．92）μg／L，P均〈0．01]；与健康组比较，差异无统计学意义[E2健晨n：（176．3±33．63）pmol／L，PRL健康组=（12．7±5．23）pg／L，P均〉0．05）]。对照组治疗后E2水平虽较同组治疗前升高[E2治疗前=（101-3±27，18）pmol／L，E2治疗后=（142．1±30．11）pmol／L，P〈0．01]，但与健康组比较，差异有统计学意义[E2健康组=（176．3±33．63）pmol／L，P〈0．01]。结论疏肝益肾法可有效干预抑郁症患者性激素分泌水平，改善患者的抑郁症状。

Objective To study the changes of sex hormone levels and the intervention of Chinese medicine female depression patients of kidney deficiency and liver depression type. Methods According to CCMD-3 and ICD-10 depressive episodes diagnostic criteria and the Chinese medicine dialectical criteria, 120 patients from March 2007 to March 2011 were selected and randomly recruited into a treatment group （n = 60） and a control group （n=60）, respectively. The treatment group was treated with traditional Chinese medicine with the functions of tonifying kidney and soothing liver, while the control group was treated with paroxetine. Both groups were treated for 12 weeks. Another healthy group of 60 eases was also setup. HAMD score and symptom score were used to observe the curative effects, the changes of E2, P, and PRL were observed in the patients and healthy persons. Results In the treatment group： E2 levels increased, PRL decreased, compared with the same group before treatment, the difference was statistically significant, [before treatment, E2= （103.6±28.24）pmol/L, after treatment, E2= （167.7±30.46）pmol/L, P〈0.01; before treatment, PRL= （32.5±7.61）μg/L, after treatment, PRL= （15.3 ± 5.92）μg/L, P〈0.01], Compared with the healthy group, the difference was not statistically significant, [healthy group E2= （176.3±33.63） pmol/L, PRL= （12.7± 5.23） μg/L, P〉0.05） ]. Although the E2 level of the control group after treatment was significantly elevated than the same group before the treatment [before treatment E2 = （101.3 ± 27.18）pmol/L, after treatment E2 = （142.1±30.11）pmol/L, P〈0.01], but compared with healthy controls, the differences were statistically significant [healthy group E2= （176.3±33.63）pmol/L, P〈0.01]. Conclusion The method of tonifying kidney and soothing liver has effective interventions on sex hormone secretion in depression patients and improvement in patients with depressive mood.