心脾两虚抑郁症临床对照研究疗效的循证医学分析

EBM Analysis of Clinical Efficacy on Clinical Control Studies of Both Deficiency and Heart and Spleen Depression

目的：评价心脾两虚抑郁症中西医结合治疗的效果。方法：应用循证医学方法对符合标准的4项研究进行分析,评价心脾两虚抑郁症在中药联合抗抑郁药物与单一治疗抑郁障碍的症状学变化,有效率、痊愈率以及与对照组的差异。结果：（1）心脾两虚抑郁症在抗抑郁药物联合中药治疗情况下,症状学改善明显于单一抗抑郁药物（Z=9.87,P〈0.01）;（2）心脾两虚抑郁症在抗抑郁药物联合中药治疗情况下,合并有效率显著高于单一抗抑郁治疗（114/142v67/117,Z=3.52,P〈0.01,OR=2.78,OR95%CI=1.58～4.92）;（3）心脾两虚抑郁症在抗抑郁药物联合中药治疗情况下,合并痊愈率虽高于单一抗抑郁治疗,但是两组之间没有统计学学的显著行差异（58/142V33/117,Z=1.76,P〉0.05,OR=1.63,OR9%CI=0.95～2.80）。结论：心脾两虚抑郁症的中西医结合治疗虽然比单一抗抑郁药物治疗某些方面有优势,但是作为抗抑郁治疗目标的痊愈问题,还需要进一步的提高。

Objective： To assess the clinical efficacy of both deficiency and heart and spleen depression by Chinese medicine integrated Western medicine. Methods ： 4 studies met our criteria were analyzed by based - evidence medicine, comparing the difference in efficacy rate, full remission rate and symptom changes after therapy. Results ： （ 1 ） The symptom changes in antidepressants combined Chinese medicine was significantly higher than that in single antidepressant in both deficiency and heart and spleen depression patients（ Z = 9.87,P 〈 0.01 ）. （2）The effective rate in antidepressant com- bined Chinese medicine was higher than that in single antidepressnt in both deficiency and heart and spleen depression patients（ 114/142 v 67/117, Z =3.52,P 〈0.01 ,OR =2.78 ,or 95% CI = 1.58 -4.92）. （3） The higher full remission rate in antidepressant combined Chinese medicine than that in single antidepressnt in both deficiency and heart and spleen depression patients was found（58/142 V 33/117, Z = 1.76 ,P 〉 0.05, OR = 1.63, or 95% CI = 0.95 ± 2.80）. Conclusion： Both Deficieney and Heart and Spleen depression patients get good therapy effieaey by antidepressant combined Chi- nese medicine, but full remission as therapy goal should be improved.