加减柴胡疏肝散治疗功能性消化不良合并抑郁症随机对照研究

Randomized controlled trial of modified Chaihu Shugan san in the treatment of functional dyspepsia complicated with depression

[目的]观察加减柴胡疏肝散治疗伴抑郁症的功能性消化不良(FD)临床疗效,并与莫沙必利+泮托拉唑组、莫沙必利+泮托拉唑+黛力新组进行比较。[方法]选取经确诊患者240例,随机分为3组,每组分别给予相应药物治疗4周。治疗前后分别给予汉密尔顿抑郁量表(HAMD)进行心理评分,测定症状积分及胃排空率;治疗1周、4周,测定依从性;停药6个月后,测定复发率。[结果]各组治疗前的症候总积分及HAMD评分比较,差异均无统计学意义。治疗后,各组症候总积分、HAMD评分均较本组治疗前显著下降(P<0.01)。其中加减柴胡疏肝散组症候积分及HAMD评分明显低于莫沙必利组+泮托拉唑组,差异有统计学意义(P<0.01及P<0.05)。加减柴胡疏肝散组疗效指数及减分率明显高于莫沙必利组+泮托拉唑组,差异有统计学意义(P<0.01及P<0.05)。各组治疗后胃排空率均较本组治疗前明显增加(P<0.01),但各组组间治疗后比较,差异无统计学意义。各组依从性治疗前后比较,治疗1周及治疗4周,加减柴胡疏肝散组及莫沙必利+泮托拉唑+黛力新组,均有明显上升,且后者高于前者,但莫沙必利+泮托拉唑组在治疗4周时有所下降。各组复发率治疗前后比较,停药6个月后加减柴胡疏肝散组最低,其次为莫沙必利+泮托拉唑+黛力新组,莫沙必利+泮托拉唑组最高,但各组比较差异无统计学意义。[结论]加减柴胡疏肝散对伴抑郁症的FD具有一定疗效,且减少复发率、增加依从性,与其改善心理状态和促进胃动力排空有关;加减柴胡疏肝散对FD症状及心理状态的改善均优于莫沙必利+泮托拉唑组。

[Objective]To observe the therapeutic effect of modified Chaihu Shugan san in treating patients with functional dyspepsia complicated with depression,and to compare it with Mosapride＋pantoprazole and Mosapride＋pantoprazole＋Deanxit.[Methods]Total 240 patients were randomly divided into three groups,corresponding medication lasted for 4weeks.The psychological scoring was performed using Hamilton depressive scale（HAMD）before and after the treatment,different indicator including the symptom score,gastric emptying rate,compliance and relapse rate in each group were compared.[Results]Before the treatment the symptoms of the HAMD scores and total integral comparison,showed no statistically significant difference among the groups.Total integral and the symptom of HAMD scores decreased significantly after the treatment（P〈0.01）.Symptom integral and HAMD scores in modified Chaihu Shugan san was obviously lower than in Mosapride＋pantoprazole,there was statistical difference（P〈0.01andP〈0.05）.Efficacy index and ratio of points in the modified Chaihu Shugan san was higher than that in the Mosapride＋pantoprazole with statistical difference（P〈0.01 and P〈0.05）.Gastric emptying rate after the treatment in each group increased with significant difference（P〈0.01）,but the comparison between groups after the treatment showed no statistical difference.The compliance rate increased in the Mosaprid＋pantoprazole＋Deanxit as compared with modified Chaihu Shugan san after the treatment of 1-week and4-week,but the rate was obviously lower after the Mosaprid ＋pantoprazole after the treatment of 4weeks.The rate of recurrence was lower in the modified Chaihu Shugan san,but there was no significant difference between groups.[Conclusion]Modified Chaihu Shugan san had certain therapeutic effects on FD patients complicated with depression.Besides,improvement of the psychological state and symptoms in the modified Chaihu Shugan san was superior to that of Mosapride＋pantoprazole.