九味镇心颗粒联合舍曲林治疗产后抑郁症的疗效观察

Clinical observation of Jiuwei Zhenxin Granules combined with sertraline in treatment of postpartum depression

目的评价九味镇心颗粒联合舍曲林应用于产后抑郁症的有效性和安全性。方法选取2012年8月—2015年3月在天津市安定医院就诊的产后抑郁症患者87名,随机分成对照组(43例)和治疗组(44例)。对照组口服盐酸舍曲林片,1片/次,1次/d。治疗组在对照组的基础上口服九味镇心颗粒,1袋/次,3次/d。两组患者均连续治疗8周。评价两组患者治疗前后临床疗效,比较汉密顿抑郁量表(HAMD)评分和血清雌二醇、孕酮水平。结果治疗2、4、8周后,对照组的总有效率分别为16.3%、44.2%、72.1%,均显著低于同期治疗组的36.4%、65.9%、86.4%,两组总有效率比较差异具有统计学意义(P<0.05)。治疗4、8周后,两组患者HAMD评分均显著下降,且治疗2周后治疗组患者HAMD评分显著下降,同组比较差异具有统计学意义(P<0.05);治疗8周后,治疗组患者HAMD评分显著低对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者雌二醇水平显著升高,孕酮水平显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组患者性激素水平改善效果优于对照组,两组比较差异具有统计学意义(P<0.05)。结论九味镇心颗粒联合舍曲林对产后抑郁症有明显的治疗作用,具有一定的临床推广应用价值。

Objective To evaluate the effect and safety of Jiuwei Zhenxin Granules combined with sertraline in treatment of postpartum depression. Methods Patients（87 cases） with postpartum depression in Tianjin Anding Hospital from August 2012 to March 2015 were randomly divided into control（43 cases） and treatment（44 cases） groups. Patients in the control group were po administered with Sertraline Hydrochloride Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Jiuwei Zhenxin Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy, HAMD score, serum estradiol and progesterone level in two groups before and after treatment were evaluated. Results After treatment for 2, 4, 8 weeks, the clinical efficacies in the control group were 16.3%, 44.2%, and 72.1%, which were significantly lower than 36.4%, 65.9%, and 86.4% in the same period of treatment group, and there were differences between two groups（P〈0.05）. After treatment for 4 and 8 weeks, HAMD score in two groups was significantly decreased, and HAMD score in the treatment group was significantly decreased after treatment for 2 weeks, the difference was statistically significant in the same group（P〈0.05）. After treatment for 8 weeks, HAMD score in the treatment group was significantly lower than that in the control group, with significant difference between two groups（P〈0.05）. After treatment, serum estradiol in two groups was significantly increased, but progesterone level was significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the improvement effect of sex hormone level in the treatment group was significantly better than that in the control group, with significant difference between two groups（P〈0.05）. Conclusion Jiuwei Zhenxin Granules combined with sertraline has obvious therapeutic effect in treatment of postpartum depression, which has a certain clinical application value.