中西医结合治疗肝郁脾虚型抑郁症30例临床疗效观察

Clinical effect of integrated traditional Chinese and Western medicine in treating liver stagnation and spleen deficiency type of depression in 30 patients

[目的]观察以疏肝健脾法中药复方快胃舒肝丸结合抗抑郁西药氟西汀治疗肝郁脾虚型抑郁症的临床疗效。[方法]选择2010年6—12月期间,在天津中医药大学第一附属医院病房及门诊连续就诊的患者60例。按随机数字表法将60例患者分为治疗组、对照组,每组30例。对照组患者服用抗抑郁药物氟西汀胶囊,治疗组患者在对照组治疗基础上加服中药复方快胃舒肝丸,治疗4周后观察临床疗效。[结果]两组在治疗后2、4周时的汉密尔顿抑郁量表(HAMD)评分、中医证候评分的减分疗效差异有统计学意义,且随着治疗时间的延长,治疗组和对照组的减分疗效均不断提高,并以治疗组的前后变化为明显,两组在治疗后第2、4周时不良反应量表(TESS)评分有显著差异,说明治疗组较对照组不良反应较少,中药可以减轻西药的不良反应。[结论]治疗组在加用中药复方快胃舒肝丸后,能够更有效的改善肝郁脾虚型抑郁症患者所伴发的消化系统症状,从而能够更好的改善精神症状。

[Objective] To observe the effect of Kuaiwei Shugan pill with action of soothing liver and strengthening spleen combined with Western medicine （fluoxetine） on liver stagnation and spleen deficiency type of depression. [Methods] The 60 patients in the ward and outpatient service in. the first affiliated hospital of Tianjin University of TCM from June to December, 2010 were selected. They were randomly divided into the treatment group and the control group, with 30 cases in each group. The patients in control group received antidepressant medication fluoxetine capsule, while the patients in treatment group received a integrated therapy of Kuaiwei Shugan pill （Chinese medicine） combined with the medicine used in control group. The clinical curative effect after treating four weeks was observed. [Results] After two weeks and four weeks treatment, the difference of two groups in Hamilton Depression Scale （HAMD） score and syndromes scores has statistically significant, and as the extension of treatment time, the curative effect of treatment group and control group constantly increased. The difference before and after treatment in treatment group was more obvious. The difference of two groups in two weeks and four weeks treatment in TESS scores was obvious, demonstrating that the side effect of treatment group was less than the control group. Chinese medicine could relieve the side effect of Westem medicine. [Conclusion] Kuaiwei Shugan pill combined with Western medicine can more effectively improve digestive system symptoms accompanied with liver stagnation and spleen deficiency type of depression, thereby can improve psychiatric symptoms better.