度洛西汀联合百合地黄汤加减治疗围绝经期抑郁症对照研究

A control study of duloxetine plus modified baihe dihuang decoction in perimeno-pausal depression

目的：探讨度洛西汀联合百合地黄汤加减治疗围绝经期抑郁症患者的临床疗效和安全性。方法将60例围绝经期抑郁症患者随机分为两组，均口服度洛西汀肠溶胶囊治疗，研究组在此基础联合百合地黄汤加减治疗，观察8周。于治疗前后采用汉密顿抑郁量表评定抑郁症状，更年期 Kupperman 评分法评估围绝经期躯体症状，副反应量表评定不良反应。结果治疗后两组汉密顿抑郁量表、更年期 Kupperman 评分法评分均较治疗前呈持续性下降，研究组治疗8周末汉密顿抑郁量表及更年期 Kupperman 评分法评分均显著低于对照组（t＝2．54、2．28，P＜0．05）；治疗8周末，观察组显效率为30．0％、总有效率为100％，对照组分别为13．3％、96．7％，两组比较无异著性差异（P＞0．05）。两组不良反应均较轻微，研究组不良反应发生率为3．3％，对照组为6．7％，两组比较差异无显著性（χ2＝0．35，P＞0．05）。结论度洛西汀联合百合地黄汤加减治疗围绝经期抑郁症患者具有协同增效作用，能有效改善患者的抑郁情绪及躯体症状，且不增加不良反应，安全性高。

Objective To explore the efficacy and safety of duloxetine plus modified baihe dihuang decoc‐tion in perimenopausal depression （PD ） .Methods Sixty PD patients were randomly divided into two groups taking orally duloxetine capsulae enterosolubilis ,on this basis research group was coupled with modified baihe dihuang decoction for 8 weeks .Deperssive symptoms were assessed with the Hamilton De‐pression Scale （HAMD） before and after treatment ,perimenopausal somatic symptoms with the Kupper‐man Menopausal Index （KMI ） ,and adverse reactions with the Treatment Emergent Symptom Scale （TESS） .Results After treatment the HAMD and KMI scores of both groups lowered continuously com‐pared with pretreatment ,those were significantly lower in research than in control group at the end of the 8th week （t= 2 .54 ,2 .28 ;P〈 0 .05） ;at the end of the 8th week obvious and total effective rate were respec‐tively 30 .0% and 100% in research and 13 .3% and 96 .7% in control group ,which showed no significant differences （P〉 0 .05） .Adverse reactions of both groups were mild ,their incidences were respectively 3 .3% in research and 6 .7% in control group ,which showed no significant differences （χ2 = 0 .35 ,P 〉0 .05） .Conclusion Duloxetine coupled with modified baihe dihuang decoction has a synergism in perim‐enopausal depression , could effectively improve patients’ depressive emotions and somatic symptoms , doesn’t increase adverse reactions ,and has higher safety .