舒肝解郁胶囊治疗肝郁气滞型甲状腺功能亢进症合并抑郁症临床研究

Effect of Shugan Jieyu Capsule Treatment on Graves Disease Complicated with Depression with Liver Qi Stagnation Type

目的观察舒肝解郁胶囊治疗肝郁气滞型甲状腺功能亢进症合并抑郁症患者的临床疗效。方法收取94例肝郁气滞型甲亢合并抑郁症患者,其中观察组47例,对照组47例。对照组给予常规控制甲亢及口服黛力新片治疗,观察组给予口服舒肝解郁胶囊治疗,2组均治疗8周。观察2组治疗前后中医症候积分、汉密尔顿抑郁量表评分(HAMD)及甲状腺功能指标,比较2组疗效。结果(1)与治疗前比较,2组治疗后中医证侯积分、HAMD评分及甲状腺功能指标FT3、FT4、s TSH、Tpo Ab、TRAb均明显改善(P<0.01,P<0.05);与对照组比较,观察组HAMD减分率及FT3、FT4、Tpo Ab、TRAb治疗前后差值明显提高(P<0.01,P<0.05),中医证候积分、不良反应发生率及抑郁症复发情况明显降低(P<0.01,P<0.05)。(2)治疗前FT4、Tpo Ab、TRAb与HAMD评分呈正相关(P<0.01),s TSH与HAMD评分呈负相关(P<0.05),FT3、FT4、Tpo Ab、TRAb治疗前后差值与HAMD减分率呈正相关(P<0.01)。(3)观察组中医证候疗效及抗抑郁综合疗效优于对照组(P<0.05)。结论舒肝解郁胶囊可改善肝郁气滞型甲状腺功能亢进症合并抑郁症患者的中医证侯、抑郁程度及甲状腺功能,药物不良反应少且抑郁症复发风险低。

Objective： To observe the curative effect of Shugan Jieyu Capsule in hyperthyroidism patients complicated depression with liver Qi stagnation type. Methods： 94 cases of hyperthyroidism patient complicated depression with liver Qi stagnation type were divided into treatment group and control group. The control group was given deanxit, and the treatment group was given Shugan Jieyu Capsule for consecutive 8 weeks. The syndrome integral of TCM, hamilton depression scale （HAMD） and thyroid function were recorded before and after treatment to evaluate the curative effect. Results： ① Compared with before treatment, the syndrome integral of TCM, HAMD score and thyroid function were improved significantly （P〈0.01, P〈0.05）. Compared with the control group, the HAMD score decrease rate and the difference of FT3, FT4, TpoAb and TRAb before and after treatment were significantly increased （P〈 0.01, P〈 0.05）, while the syndrome integral of TCM, the adverse effects rate and FT3 were significantly reduced （P〈 0.01, P〈 0.05）. ② The HAMD score was correlated positively with FT4, TpoAb, TRAb before treatment but negatively with sTSH （P〈0.01, P〈 0.05）. The differences of FT3, FT4, TpoAb and TRAb before and after treatment were correlated positively with HAMD score decrease rate （P〈 0.01）. ③ The treatment group was superior to control group in clinical efficacy of TCM syndrome and depression （P〈 0.05）. Conclusion： Shugan Jieyu Capsule can improve the clinical symptoms of TCM, depression degree and thyroid function in hyperthyroidism patients complicated depression with liver Qi stagnation type, with less recurrence risk of depression and adverse drug reactions.