参芪解郁方对产后抑郁症患者雌、孕激素及EPDS评分的影响

Effect of Shenqi Jieyu Formula on estrogen progestogen and EPDS in postpartum patients with depression

目的评价参芪解郁方治疗心脾两虚证产后抑郁症的有效性和安全性。方法以随机、对照、盲法为原则,将符合纳入标准的60例产后抑郁心脾两虚症患者随机分组治疗组与安慰剂组各30例。治疗组口服参芪解郁颗粒,每日1剂;安慰组采用淀粉糊精颗粒,每日1剂,疗程均为6周。分别于治疗前,治疗后1、2、4、6周应用爱丁堡产后抑郁量表(EPDS)进行疗效评价,同时测定治疗前后血清的雌二醇(E2)及孕酮(P)水平。结果治疗6周,治疗组EPDS减分率总有效率为86.67%,临床控制率26.67%;安慰剂组EPDS减分率总有效率为70.00%,临床控制率为0。治疗组在治疗1、2、4、6周时EPDS评分与治疗前差异有统计学意义(P<0.01),第1、2、4、6周时疗效优于安慰剂组(P<0.05)。治疗6周后,2组E2水平与治疗前比较差异均有统计学意义(P<0.05);治疗组疗效优于安慰剂组(P<0.05)。2组治疗6周后血清P水平与治疗前比较差异有统计学意义(P<0.05),但2组间比较差异无统计学意义(P>0.05)。结论中药参芪解郁方可有效改善产后抑郁心脾两虚证患者EPDS评分,降低血清P水平,提高血清E2水平,不良反应小。

Objective To evaluate the efficacy and safety of Shenqi Jieyu Formula to treat postpartum patients with depression（ PPD）of heart and spleen deficiency syndrome. Methods According to the principles of random,control and double-blind,60 cases of PPD with heart and spleen deficiency,who conformed to the inclusion principles,were divided into 2 groups of 30 cases respectively in the treatment group and in the placebo group. The treatment group took Shenqi Jieyu Granules orally 1 dose / day. The placebo group took starch granules 1 dose / day. Both groups adopted 6 weeks＇ treatment. EPDS was used before treatment,in the 1st week,2nd week,4th week,6th week after treatment to evaluate the therapeutic effect,and at the same time,serum estradiol（ E2） and progesterone（ P） levels before and after treatment were measured. Results In the 6 weeks＇ treatment,EPDS showed deducted rate,the total effective rate was 86. 67% and the clinical control rate 26. 67% in treatment group; that in placebo group was 70. 00% and 0%respectively. EPDS deducted rate difference in 2 groups in the 2nd week,4th week,6th week＇s treatment was statistically significant（ P 0. 05）. After 6 weeks＇ treatment,the difference in E2 level before and after the treatment in both treatment group and placebo group was statistically significant（ P 0. 05）,the effect of treatment group was better than that of the placebo group（ P 0. 05）.After 6 weeks＇ treatment,the difference of serum progesterone levels before and after the treatment in both groups was statistically significant（ P 0. 05）. But the difference between the two groups was not statistically significant（ P 0. 05）. Conclusion Shenqi Jieyu Formula can effectively improve EPDS,decrease serum progesterone levels,and enhance serum E2 levels in patients of PPD of heart and spleen deficiency syndrome with less adverse effects.