健脾舒肝汤治疗肝郁脾虚型抑郁障碍相关性失眠疗效观察

Observation on therapeutic effect of Jianpishugan decoction in treating depression-related insomnia with depression of liver-qi and spleen-deficiency

目的:探讨自拟健脾舒肝汤对肝郁脾虚型抑郁障碍相关性失眠患者临床疗效及对神经相关性因子水平的影响。方法:将120例中医辨证分型为肝郁脾虚型抑郁障碍相关性失眠患者分为观察组及对照组各60例,对照组给予盐酸帕罗西汀口服治疗,观察组口服自拟健脾舒肝汤,两组治疗时间为6周,比较两组治疗效果。结果:观察组总有效率略高于对照组(P>0.05)。两组治疗后HAMD评分、PSQI评分低于治疗前(P<0.05),观察组治疗后PSQI评分均低于对照组(P<0.05)。观察组患者治疗后血清SP水平显著低于对照组,而5-HT、NPY水平高于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论:自拟健脾舒肝汤抗抑郁效果与盐酸帕罗西汀相当,但自拟健脾舒肝汤能有效改善肝郁脾虚型抑郁障碍相关性失眠患者睡眠障碍及神经紊乱症状,且不良反应发率低。

Objective：To investigate the clinical curative effect of self-made Jianpishugan decoction on depression-related insomnia with depression of liver-qi and spleen-deficiency and its influence on the level of nerve related factors.Methods：120 cases of patients with depression-related insomnia with depression of liver-qi and spleen-deficiency were divided into two groups：the observation group （n=60） and the control group （n=60）.The control group were received with oral paroxetine hydrochloride and observation group were received with Jianpishugan decoction for 6 weeks.The treatment effect of two groups were compared.Results：The total effective rate of the observation group was slightly higher than that of the control group.After treatment,the HAMD score and PSQI score of two groups were lower than before treatment （P〈0.05）,and the PSQI score of observation group were lower than the control group （P〈0.05）.The level of serum SP in the observation group was significantly lower than that in the control group, the levels of 5-HT and NPY were higher than in the control group （P〈0.05）.The complication rate of the observation group was lower than that of the control group （P〈0.05）.Conclusion：The antidepressant effect of Jianpi Shugan decoction is equivalent to that of Paroxetine Hydrochloride, but self-made Jianpushugan decoction can effectively improve the symptoms of sleep disorders and neurological disorders in patients with depression-related insomnia with depression of liver-qi and spleen-deficiency.Low incidence of adverse reactions.