柴胡疏肝散对恶性肿瘤伴抑郁症患者的临床疗效观察

A Clinical Study of Chaihu Shugan Powder in the Treatment of Malignant Tumor Patients with Depression

[目的]观察中药消痰解郁方联合西药氟西汀对于恶性肿瘤伴抑郁症患者的临床疗效。[方法]恶性肿瘤伴抑郁症患者90例,随机分为对照组(n=45)和治疗组(n=45),对照组给予氟西汀胶囊(20mg/d),治疗组给予柴胡疏肝散,水煎服,1日1剂,疗程为6周。分别在治疗前和治疗后1周、3周、6周采用汉密尔顿抑郁量表评分法进行评分;通过汉密尔顿抑郁量表减分率评价疗效,观察不良反应,评价其安全性。[结果]与治疗前相比,治疗组患者治疗1周后汉密尔顿抑郁量表评分明显下降[(20.78±1.24)vs(24.87±5.12),P<0.05],在治疗后3周、治疗后6周,下降更为显著[(16.34±3.67)vs(24.87±5.21),P<0.05]、[(11.78±3.21)vs(24.87±5.12),P<0.01]。对照组患者在治疗3周时汉密尔顿抑郁量表评分比治疗前明显下降[(18.77±2.54)vs(25.67±4.34),P<0.05]。治疗组患者经柴胡疏肝散治疗6周后,总有效率达84.4%,与对照组(77.8%)相比,差异有统计学意义(P<0.05),不良反应发生率明显降低(17.7%vs44.4%,P<0.05)。[结论]柴胡疏肝散能显著改善恶性肿瘤患者的抑郁症状,比氟西汀具有更好的疗效和安全性。

[ Purpose] To evaluate the efficacy and the security of Chaihu Shugan powder com- pared with fluoxetine in the treatment of malignant tumor patients with depression. [Methods] Ninety cancer patients with depression weir collected,and randomly divided into control group （n=45） and treatment group （n=45）.Control group was given fluoxetine （20mg/d）. The treatment group received Chaihu Shugan,deeoetion, 1d/stuff, treatment for 6 weeks. The changes of the HAMD score were observed before and after one,three,six weeks＇ treatment,and the adverse reaction was rec.orded in the end of the study. [Resuhsl Compared with before treatment,the HAMD score was markedly decreased in treatment group after one weeks＇ treatment[（20.78±1.24） vs （24.87±5.12）,P〈0.051,and even more significantly after three and six weeks＇ treatment [（16.34±3.67） vs （24.87±5.21）,P〈0.05], [（11.78±3.21） vs （24.87±5.12）,P〈0.01 ]. The HAMD score in control group also decreased after treated for 3 weeks compared with before treatment [（18.77±2.54） vs （25.67±4.34）,P〈0.05）. Patients treated by Chaihu Shugan after 6 weeks cff treatment,the total efficiency was 84.4%. Compared with the control group （77.8%）,the differ- ence was statistically significant （P〈0.05）. Chaihu Shugan significantly lower incidence of ad- verse reactions （17.7% vs 44.4%,P〈0.05）. [Conclusionl Chaihu Shugan powder significantly al- leviate the depression in patients with malignant tumor. It has better efficacy and safety than flu- oxetine. Subject words： neoplasms;depression;Chaihu Shugan powder;fluoxetine