归脾汤治疗心脾两虚型抑郁症30例

Guipi Decoction for Treating 30 Cases of Heart-spleen Deficiency Depression

目的:探讨归脾汤与氟西汀治疗心脾两虚型抑郁症的疗效比较。方法:将60例抑郁症心脾两虚型患者,随机按数字法分为归脾汤组和氟西汀组各30例。氟西汀组口服氟西汀,20 mg/次,1次/d;归脾汤组口服归脾汤加减治疗,1剂/d,分2次服用;两组疗程均为6周。在治疗的第1,2,4,6周时,分别对两组患者进行汉密顿(HAMD)量表评分及中医症状量表评分,两组治疗后的HAMD疗效有效率以及中医症状疗效有效率进行对比,并记录不良反应。结果:归脾汤组和氟西汀组的HAMD疗效有效率随治疗时间不断提高,在治疗后第1周时,归脾汤组总有效率为3.33%,氟西汀组总有效率为0%,归脾汤组总有效率高于氟西汀组(P<0.01);而在治疗后第2,4,6周时两组的有效率差异无统计学意义。两组的中医症状疗效有效率亦随治疗时间不断提高,在治疗后第1周时,归脾汤组总有效率为10%,氟西汀组总有效率为3.33%,归脾汤组总有效率高于氟西汀组(P<0.01);在治疗后第2周时归脾汤组总有效率为53.33%,氟西汀组总有效率为16.67%,归脾汤组总有效率亦高于氟西汀组(P<0.01);在治疗后第4,6周时两组的总有效率差异无统计学意义。归脾汤组不良反应发生率为0%,氟西汀组治疗过程中出现腹泻1例,患者于治疗1周后脱落,不良反应发生率为3.33%(P<0.01)。结论:归脾汤可显著提高心脾两虚型抑郁症患者的HAMD量表及中医症状量表减分率,与氟西汀治疗比较疗效相当,但比服用氟西汀后的不良反应少,起效更早。服用归脾汤是治疗心脾两虚型抑郁症安全有效的方法。

Objective：To investigate the therapeutic effect of Guipi decoction compared with Fluoxetine for depression patients with Heart-spleen deficiency.Method：Sixty cases of patients were randomly divided into Guipi decoction group and the Fluoxetine group with 30 cases in each group.Patients were given with Fluoxetine （20 mg,once a day） in the Fluoxetine group and Guipi decoction was given （half of one decoction,twice a day） in the treatment group.The treatment course was 6 weeks.Hamilton rating scale for depression （HAMD） and traditional chinese medicine （TCM） symptoms scale were measured at week 1,2,4,and 6 after the treatment,and the effective rate was assessed according to HAMD and TCM symptoms scale to evaluate therapeutic effects.Adverse reactions were recorded.Result：Both of the effective rates of HAMD and TCM symptoms increased in two groups along with treatment time.After the first week of treatment,the total effective rate of HAMD in Guipi group （3.33％） was higher than that in the Fluoxetine group （0％） （P ＜0.01）.However,there was no difference for total effective rate of HAMD between groups after 2,4,or 6 weeks of treatment.The total effective rate of TCM symptoms in Guipi group were 10％ and 53.33％ after first and second week of treatment respectively,which were significantly higher （P ＜0.01） than that in the Fluoxetine group （3.33％ and 16.67％）.But no difference was found for effective rate of TCM symptoms between groups after 4 or 6 weeks of treatment.Furthermore,no adverse event was found in Guipi decoction group,while 1 case was dropped out after one week of treatment because of diarrhea in the Fluoxetine group,thus indicated the adverse reaction rate was 3.33％ in the Fluoxetine group （P ＜0.01）.Conclusion：Compared to Fluoxetine,Guipi decoction has similar effect on improving HAMD scores and TCM symptoms for depression patients with Heart-spleen deficiency,but it has fewer adverse reactions and faster onset of action.In conclusion,Guipi decoction is safe and effective for Heart-spleen deficiency depression.