加味甘麦大枣汤对更年期抑郁症患者神经内分泌系统的影响

Effects of modified Ganmai Dazao decoction on neuroendocrine system in patients with climacteric depression

研究加味甘麦大枣汤对阳虚型更年期抑郁症患者的临床疗效及对患者神经内分泌系统的影响。采用随机双盲对照法,将86例属于阳虚型更年期抑郁症患者随机分为治疗组和对照组,分别予以口服加味甘麦大枣汤和黛立新治疗,于治疗前、治疗2,4周后进行汉密尔顿抑郁量表(HAMD)的评分和匹兹堡睡眠质量量表(PSQI)评分,评价总体疗效,并于治疗前及治疗4周后测定患者血清单胺类神经递质5-羟色胺(5-HT)、去甲肾上腺素(NE)、雌二醇(E2)、促卵泡激素(FSH)、促黄体生成素(LH)水平。结果显示治疗组有效率为88.4%,对照组有效率为81.4%,2组无显著差异;治疗后2,4周与治疗前HAMD评分比较2组均显著降低(P<0.01),2组间同时段比较并无显著性差异;治疗后2,4周与治疗前PSQI评分比较均显著降低(P<0.05),治疗4周后治疗组与对照组PSQI评分比较有差异显著(P<0.01)。治疗4周后2组血清5-HT,NE水平较治疗前均明显升高(P<0.01),2组间比较差异无显著性;治疗4周后治疗组血清E2水平明显升高(P<0.05),FSH水平明显降低(P<0.05),LH水平有所降低,但无统计学意义,2组间比较差异无显著性。该研究提示加味甘麦大枣汤在治疗更年期抑郁症方面具有良好的作用,其临床总体疗效与黛力新相当,在改善睡眠障碍方面优于黛力新。对其作用机制研究提示加味甘麦大枣汤可能通过调整抑郁症患者5-HT,NE,E2,FSH,LH水平干预更年期抑郁症患者神经内分泌系统,从而改善患者临床症状。

Clinical study of modified Ganmai Dazao decoction in the treatment of yang deficiency climacteric depression and observe the effects of modified Ganmai Dazao decoction on neuroendocrine system in patients with yang deficiency climacteric depression. 86 cases were randomly divided into treatment group treated with modified Ganmai Dazao decoction and control group treated with Deanxit. The curative effect was evaluated with Hamilton＇s depressive scale （HAMD） and pittsburgh sleep quality scale（PSQI） before and at the end of the two and four weeks of the treatment, the serum levels of serotonin （5-HT）, norepinephrine （ NE）, estradiol （E2）, follicle stimulating hormone （FSH）, luteotropic hormone （LH）were detected before and after the four weeks of the treatment. The results showed that the total effective power of treatment group was 88.4% and the total effective power of control group was 81.4% after four weeks interference, with insignificant difference between the two groups. After two and four weeks of the treatment, the score of HAMD decreased remarkably in both groups （P 〈0. 01 ）, with insignificant difference between the two groups in same phase. After two and four weeks of the treatment, the total score of PSQI decreased remarkably in both groups （P 〈 0. 05 ）, with significant difference between the two groups after four weeks（P 〈0. 01 ）. After four weeks of treatment, the serum levels of 5-HT and NE increased（P 〈0. 01 ）, with insignificant difference between the groups. After four weeks of treatment, the serum levels of E2 increased obviously （ P 〈 0.05 ）, the levels of FSH decreased obviously （ P 〈0. 05 ）, the levels of LH decreased insignificant, with insignificant difference between two groups. This study indicates that modified Ganmai Dazao decoction has obvious therapeutic effects in the treatment of climacteric depression, and showed equivalent efficacy with Deanxit, and modified Ganmai Dazao decoction has better effect on improving the sleep quality in patients than Deanxit, the effect of improved clinical symptoms may be through adjusted levels of 5-HT, NE, E2, FSH and LH of climacteric depression.