舒肝解郁胶囊治疗伴有抑郁症状功能性消化不良患者近期疗效观察

Short-term efficacy of shuganjieyu capsule in treatment of functional dyspepsia patients with depressive symptoms

[目的]探讨舒肝解郁胶囊治疗伴有抑郁症状功能性消化不良(FD)患者的临床疗效及对生活质量的影响。[方法]采用汉密尔顿抑郁评分量表(HAMD-17)及健康调查简易量表(SF-36量表)评定伴有抑郁症状FD患者95例(FD组)、健康体检者90例(健康对照组)的抑郁状况及生活质量。将FD组按不同的治疗方法随机分为2亚组:治疗亚组(48例)、对照亚组(47例),对照亚组临床上给予雷贝拉唑片和(或)枸橼酸莫沙必利分散片治疗,治疗亚组在对照亚组基础上加用舒肝解郁胶囊,疗程为6周,分别记录2组治疗前及治疗后1周、2周、3周、6周末的抑郁状况及生活质量,并比较2组治疗效果、不良反应和复发率。[结果](1)FD组HAMD-17评分为(22.15±8.06)分,高于健康对照组,2组比较差异有统计学意义(P<0.01);生活质量评定中躯体健康评分(physical component summary,PCS)为(32.16±12.79),精神健康评分(Mental component summary,MCS)为(38.16±17.10),均低于健康对照组,2组比较差异有统计学意义(P<0.05)。(2)治疗亚组治疗前、后HAMD-17评分分别为(22.18±8.02)分、(13.16±3.48)分,PCS评分分别为(32.12±10.76)分、(56.98±18.32)分,MCS评分分别为(35.17±14.03)分、(67.29±19.32)分,治疗前、后比较均差异有统计学意义(P<0.05);治疗亚组与对照亚组比较,PCS、MCS评分在治疗2周后至6周末均差异有统计学意义(P<0.05),HAMD-17评分在治疗6周末差异有统计学意义(P<0.05)。(3)治疗亚组总有效率87.50%明显优于对照亚组,2组比较差异有统计学意义(χ2=11.85,P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05),且症状轻微未中断治疗;治疗亚组的复发率明显低于对照亚组,2组比较差异有统计学意义(P<0.05)。[结论]FD患者伴有明显抑郁、生活质量降低,舒肝解郁胶囊可以提高伴有抑郁症状FD的治疗效果,能明显提高患者生活质量,起效时间在1周左右,且不良反应少,复发率低,值得临床推广应用。

To explore the effect of Shuganjieyu capsule on the clinical symptoms and quality of life of patients with functional dyspepsia（FD）with depressive symptoms. [Methods]A total of 140 pa-tients with functional dyspepsia were evaluated by the Hamilton Depression Rating Scale（HAMD-17）and the Health Survey Scale（SF-36）and 95 patients were diagnosed to have the symptom of depression. Ninety healthy was set as healthy control. In the 95 FD patients with depression,they were randomly divided into two groups.the treatment group（48 cases）and the control group （47 cases）, the patients in control group were given rabeprazole tablets or citrate mosquito dispersible tablets. The patients in treatment group were treated with Shuganjieyu capsule additionally. The course of treatment was 6 weeks. The levels of depres- sion and quality of life were recorded before treatment, 1 week,2 weeks, 3 weeks and 6 weeks after the treatment respectively. The treatment effect, adverse reactions and relapse rates were compared. [Results] （1）The HAMD-17 score of functional dyspepsia was 22.15 ± 8.06,which was higher than that of healthy control group （P 〈 0.01 ）. Physical quality summary （PCS）, Mental health score （MCS） were significantly lower than the healthy control group（P〈0.05）. （2）Compared with the control group,the HAMD-17 score in treatment group decreased from 22.18 ± 8.02 to 13.16± 3.48 before and after treatment. The PCS score increased from 32.12± 10.76 to 56.98± 18.32,and the MCS score increased from 35.17 ± 14.03 to 67.29 ± 19.32,P〈0.05. Compared with the control group,the scores of PCS and MCS in treatment group were statistically different（P〈0.05）at 2 weeks and 6 weeks after treatment, and the HAMD-17 score was statistically different at 6 weeks after treatment（χ^2= 11.85 ,P〈0.05）. There was no significant difference in the incidence of adverse reactions between the two groups（P〉 0.05）. （3）The total effective rate was 87.50% in the treatment group,which was significantly better than that in the control group） ,and the symptoms were slightly uninterrupted ; the recurrence rate in the treatment group was significantly low er than that in the control group,the difference was statistically significant（P〈0.05）. [Conelusian]The pa- tients with functional dyspepsia are significantly depressed and the quality of life is reduced. Shugan Jieyu Capsule can improve the treatment effect of depressive symptoms in functional dyspepsia,and the quality of life can be improved obviously. The onset time is about 1 week, and it＇s less adverse reactions, low recur rence rate,worthy of clinical application.