乌灵胶囊联合舍曲林治疗产后抑郁的疗效观察及对体内雌、孕激素和孤啡肽的影响

A Research of Wuling Capsule Combined with Sertraline in the Treatment of Postpartum Depression and the Change of Hormone and Neuro-transmitter in vivo

[目的]研究乌灵胶囊联合舍曲林治疗产后抑郁症(post partum depression,PPD)的疗效以及对体内雌二醇、孕酮、孤啡肽水平的影响。[方法]将63例PPD患者随机分成观察组(31例)予乌灵胶囊和舍曲林治疗,对照组(32例)予舍曲林治疗,疗程均为4周,通过治疗前后爱丁堡产后抑郁量表(edinburgh postnatal depression scale,EPDS)评分降低率评定两组疗效和不良反应发生情况。在治疗前后分别用放射免疫法测患者血清的雌二醇水平、孕酮水平、孤啡肽水平,用高效液相色谱检测患者血清的5-羟色胺水平。[结果]观察组的有效率为96.77%,对照组为81.25%,两组的有效率比较,差异有统计学意义(P<0.05);不良反应比较,差异无统计学意义(P>0.05)。与治疗前比较,两组治疗后的雌二醇、孕酮、孤啡肽、5-羟色胺水平变化均有统计学意义(P<0.05)。治疗后观察组的雌二醇、5-羟色胺升高水平高于对照组(P<0.05),孕酮、孤啡肽下降水平明显高于对照组(P<0.05)。[结论]乌灵胶囊和舍曲林联用可通过影响患者的激素水平和神经递质的改变而达到更显著的疗效,值得临床进一步研究。

[Objective] To observe Wuling Caps combined with Sertraline in the treatment of postpartum depression and the change of estradiol and progesterone in vivo. [Methods] 63 patients of postpartum depression were divided randomly into two groups：31 cases in treatment group were treated by Wuling Capsule combined with sertraline, another 32 in control group were treated by sertraline. The number of effective cases and adverse effect was observed. The concentrations of serum estradiol, progesterone, orphanin were measured by radioimmunity before and after treatment, while 5-HT was measured by HPLC. [Results] 30 cases were effective in observed group, while 26 cases in control group. There was significant difference about number of effective cases, and no significant difference about adverse effect（ P＆gt;0.05）. In observed group, the increase level of estradiol and 5-HT was higher than that in control group（P〈0.05）, and the decrease level of progesterone and orphanin in observed group was higher than that in control group（ P〈0.05）. [Conclusions] Wuling Caps combined with sertraline had a better effect, and also effected the change of some kinds of hormone and neurotransmitter. So it was worthy to be further researched and applied.