加味温胆汤与氟西汀治疗抑郁症的临床对照研究

Controlled clinical studies of treating depression between Jiawei Wendan Decoction and Fluoxetine

目的对比观察加味温胆汤与氟西汀治疗抑郁症的临床疗效。方法将60例抑郁症患者随机分为中药组和对照组,对照组30例给予盐酸氟西汀胶囊,中药组30例给予加味温胆汤,疗程均为6周。治疗前及治疗2周后、4周后、6周后采用汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、中医症候量表进行评分;治疗前后采用神经心理学测验评价执行功能变化以及6周末采用抗抑郁药副反应评定量表(rating scale for side effects,SERS)评价不良情况。结果治疗6周后,两组患者临床疗效相当,可明显改善治疗前HAMD评分,两组未显示统计学差异(P>0.05);中药组从治疗4周后开始对中医证候具有明显改善作用,与对照组有明显差异,有统计学意义(P<0.05);6周末两组的基本执行功能总分值存在差异(P<0.05),有统计学意义,主要表现在威斯康星卡片分类测验(Wisconsin card sorting test,WCST)总正确数、汉诺塔测验(tower of Hanoi,TOH)平均计划时间、连线测试(trail making test-B,TMT-B)错误数方面中药组得分高于对照组;6周末中药组的(SERS量表评分)不良反应发生率(13.4%)明显低于对照组(30.4%)。结论加味温胆汤对抑郁症具有良好的临床治疗效果。

Objective To investigate curative effect of treating depression with Jiawei Wendan De- coction and fluoxetine respectively. Methods 60 depression patients were randomly divided into traditional Chinese medicine group and control group. 30 patients of control group were treated with Fluoxetine ; 30 patients of traditional Chinese medicine group were treated with Jiawei Wendan Decoction. Both groups were treating 6 weeks as a course of treatment. To evaluate curative effect and side effect, Hamilton depres- sion （HAMD） scale score and traditional Chinese medicine （TCM） syndromes were measured in both groups at the end of the Oth, the 2nd, 4th, 6th week; neuropsyehological tests were measured in both groups before and after treatment; rating scale for side effects （SERS） was checked in both groups at the end of 6th week. Results At the end of the 6th week, we found that there were no significant differences between the two groups （ P 〉 0. 05 ） in the curative effect and the scores of HAMD ; and, the changes differences of TCM symptoms between two groups were significant （ P 〈 0. 05 ） from the 4th week ; and in the traditional Chinese medicine group the scores of basic neurocognitive functioning, such as the continue errors of Wisconsin card sorting test （WCST）, total scores of tower of Hanoi （TOH）, errors of trail making test-B（TMT-B）, were obviously higher than the control group （P 〈 0. 05）. However, at the end of 6th week, the extent of adverse reaction （rating scale for side effects, SERS） in the traditional Chinese medicine group （ 13.4% ） was lower than that in the control group Decoction has a good curative effect in treating depression.