柴胡疏肝散联合氟西汀对产后抑郁症患者IL-6、IL-1β、TNF-α的影响及其疗效

Effect of Chaihushugansan combined with fluoxetine on IL-6,IL-1β,TNF-α in postpartum depression

目的观察柴胡疏肝散联合氟西汀对产后抑郁症患者IL-6、IL-1β、TNF-ɑ因子的影响。方法选取嘉兴市妇幼保健院科室2013年11月~2015年7月收治的产后抑郁症患者共83例,按随机数字表法分为观察组41例和对照组42例,对照组给予氟西汀药物治疗,观察组在对照组基础上给予柴胡疏肝散联合治疗,随访并记录2组患者汉密尔顿抑郁量表评分（HAMD）、汉密尔顿焦虑量表评分（HAMA）、白介素-6（IL-6）、白介素-1β（IL-1β）、肿瘤坏死因子（TNF-α）、超敏C反应蛋白（hs-CRP）及不良反应情况。结果观察组患者治疗后HAMD、HAMA评分分别为（8.31±2.05、9.03±2.08）分,均低于对照组（13.96±2.16、13.61±2.14）分（P〈0.05）。观察组患者治疗后IL-6和IL-1β分别为（6.59±3.20、5.01±2.83）pg/m L,均低于对照组（10.64±3.86、9.31±3.42）pg/m L（P〈0.05）。观察组患者治疗后TNF-ɑ和hs-CRP值分别为（9.16±2.01）pg/m L、（3.62±1.06）mg/L,均低于对照组（12.30±2.37）pg/m L、（5.29±1.14）mg/L（P〈0.05）。观察组治疗过程中总不良反应率为7.32%,明显低于对照组23.81%,且差异具有统计学意义（P〈0.05）。结论柴胡疏肝散联合氟西汀对产后抑郁患者有良好的治疗作用,可明显降低IL-6、IL-1β、TNF-ɑ水平,且不良反应较小,其效果优于单独应用氟西汀治疗。

Objective To observe the effect of Chaihushugansan combined with fluoxetine on interleukin-6（ IL-6）,interleukin-1β（ IL-1β）,tumor necrosis factor（ TNF-ɑ） in the treatment of patients with postpartum depression. Methods 83 patients from November 2013 to July 2015 in Jiaxing Maternity and Child Health Care Hospital were randomly divided into 41 patients of observation group and 42 patients of control group. The control group were treated with fluoxetine treatment,the obsercation group received Chaihushugansan on the basis of control group. The Hamilton depression scale（ HAMD） and Hamilton anxiety scale（ HAMA）,IL-6,IL-1β,TNF-ɑ,high-sensitivity C-reactive protein（ hs-CRP） and adverse reactions were followed up and recorded. Results The HAMD and HAMA score in observation group post-treatment were（ 8. 31 ± 2. 05,9. 03 ± 2. 08） points,which were lower than（ 13. 96 ± 2. 16,13. 61 ± 2. 14） points in control group（ P〈0. 05）. The serum IL-6 and IL-1β levels in observation group post-treatment were（ 6. 59 ± 3. 20,5. 01 ± 2. 83） pg/m L,which were lower than（ 10. 64 ± 3. 86,9. 31 ± 3. 42） pg/m L in control group（ P〈0. 05）. The serum TNF-ɑ and hsCRP levels in observation group post-treatment were（ 9. 16 ± 2. 01） pg / m L,（ 3. 62 ± 1. 06） mg / L,which were lower than（ 12. 30 ± 2. 37） pg / m L,（ 5. 29 ± 1. 14） mg/L in control group（ P〈0. 05）. The total adverse reaction rate in observation group was 7. 32%,significantly lower than 23. 81% in control group（ P〈0. 05）. Conclusion Chaihushugansan combined with fluoxetine has a good therapeutic effect in the treatment of postpartum depression,could significantly reduce the IL-6,IL-1β,TNF-ɑ levels,with fewer side effects,it is better than fluoxetine alone.