疏肝解郁胶囊联合度洛西汀治疗帕金森患者抑郁的临床效果

Clinical effect of Shugan Jieyu Capsules combined with Duloxetine in the treatment of depression in patients with parkinson disease

目的观察探讨疏肝解郁胶囊联合度洛西汀治疗帕金森病(PD)患者抑郁的临床效果。方法将2016年2月~2017年6月在我院精神科门诊就诊的73例PD并发抑郁者作为研究对象,按照随机数字表法将其随机分为对照组(36例)与联合组(37例),其中对照组患者仅给予盐酸度洛西汀肠溶片治疗,联合组患者则同时给予疏肝解郁胶囊治疗,以4周为1个疗程,均连续治疗2个疗程。比较两组患者治疗前,治疗第4、8周时的汉密尔顿抑郁评分(HAMD)、统一帕金森病评分第三部分(UPDRS-Ⅲ)评分、日常生活能力量表(ADL)评分。治疗第8周时根据HAMD减分率比较两组患者的治疗效果,同时比较两组患者治疗过程中的不良反应发生情况。结果治疗第4、8周时,两组患者的HAMD、UPDRS-Ⅲ评分均明显降低,ADL评分明显升高,与治疗前比较,差异有统计学意义(P<0.05),且治疗第8周时,联合组患者的HAMD、UPDRS-Ⅲ明显低于对照组(P<0.05),治疗第4、8周时,联合组患者的ADL评分均明显高于对照组(P<0.05)。治疗第8周时,联合组患者的总有效率为91.89%,明显高于对照组的71.31%(P<0.05)。联合组患者药物不良反应发生率为13.51%,与对照组的19.44%比较,差异无统计学意义(P>0.05)。结论对PD并发抑郁患者应用疏肝解郁胶囊联合度洛西汀治疗的效果显著,两者可协同作用,加强改善患者抑郁症状的效果,同时有助于改善PD患者的日常生活能力和运动能力,且不会增加不良反应,值得临床推广应用。

Objective To observe the clinical effect of Shugan Jieyu Capsules combined with Duloxetine in the treatment of depression in patients with parkinson disease （PD）.Methods 73 PD patients with depression treated in outpatient of the psychiatry department of our hospital from February 2016 to June 2017 were selected as object and they were randomly divided into the control group （36 cases） and combined group （37 cases）.Patients in the control group were treated with Duloxetine Hydrochloride Enteric-coated Tablets,while the patients in the combined group were treated with Shugan Jieyu Capsules at the same time.4weeks were a course of treatment and the patients were treated continuously for 2 courses.The score of HAMD,UPDRS-]]I and ADL before treatment and at the fourth,eighth week of treatment were compared in patients between the two groups.At the eighth week of treatment,the treatment effect between the two groups was compared according to HAMD reduction rate,and the incidence of adverse reactions during the treatment of the two groups was compared at the same time.Results At the fourth and eighth weeks treatment,the score of HAMD,UPDRS-Ill in the two groups were significantly decreased,ADL score was obviously increased,and there was a statistical difference compared with before treatment （P〈0.05）.At the eighth weeks treatment,the score of HAMD and UPDRS- III of the patients in the combined group were significantly lower than those in the control group （P〈0.05） and at the fourth and eighth weeks treatment,ADL score of the patients in the combined group was significantly higher than that in the control group （P〈0.O5）.At the eighth weeks,the total effective rate of the patients in the combined group was 91.89%,which was significantly higher than that of the control group （71.31%） （P〈0.05）.The incidence of adverse drug reactions in the combined group was 13.51%,compared with 19.44% in the control group,the difference was not statistically significant （P〉0.05）.Conclusion The combination of Shugan Jieyu Capsules combined with Duloxetine is effective in the treatment of PD complicated with depression,both can work together to strengthen the effect of depressive symptoms,help improve the daily living ability and exercise ability of patients,and can reduce the incidence of adverse drug reaction,it is worthy of clinical promotion and application.