归脾汤治疗成人抑郁症临床疗效及对患者血浆5-羟色胺和去甲肾上腺素水平的影响

Effect of Guipi Decoction on Depression in Adults and Its Effect on Plasma Levels of 5-HT and Norepinephrine

目的探讨归脾汤治疗成人抑郁症临床疗效及对患者血浆5-羟色胺和去甲肾上腺素水平的影响。方法选取2014年9月-2016年1月沈阳市第二中医医院收治的84例抑郁症患者为研究对象，随机分为观察组和对照组各42例。两组患者均给予情绪疏导和行为干预，并口服西药舍曲林片治疗，观察组在此基础上加服归脾汤治疗。按汉密顿抑郁量表（HAMD）总分减分率进行疗效评定，评估两组治疗前后HAMD评分和抑郁自评量表（SDS）评分改善情况，并测定两组血浆5-羟色胺、去甲肾上腺素水平。结果观察组临床总有效率高于对照组，差异有统计学意义伊〈0．05）；两组治疗前HAMD评分和SDS评分比较，差异无统计学意义（P〉0．05），治疗14d、30d后均较治疗前降低，差异有统计学意义（P〈0．05），且治疗14d、30d观察组HAMD评分和SDS评分均低于对照组，差异有统计学意义（P〈0．05）；两组治疗前血浆5-羟色胺、去甲肾上腺素水平比较，差异无统计学意义（P〉0．05），治疗14d、30d均较治疗前改善，差异有统计学意义（P〈0．05），且治疗14d、30d观察组5一羟色胺水平高于对照组，去甲肾上腺素水平低于对照组，差异有统计学意义（P〈0．05）；两组患者治疗期间均未出现严重不良反应情况。结论中药归脾汤可通过改善血浆5一羟色胺、去甲肾上腺素水平提高抑郁症的临床治疗疗效，对减轻患者抑郁程度和改善心理状态有积极作用。

Objective To investigate the effect of Guipi decoction on depression in adults and its effect on plasma levels of 5-HT and norepinephrine. Methods A total of 84 depressive patients were collected in Shenyang Second Traditional Chinese Medicine Hospital from September, 2014 to January, 2016, and were randomly divided into observation group （n=42 cases） and control group （n=42 cases）. All patients were given emotional counseling and behavioral interventions, and received the sertraline orally. Based on the same treatment, the patients in observation group received the Guipi decoction. Hamilton depression scale （HAMD） reducing rate was regarded as the criteria to assess the therapeutic effect, and the scores of HAMD and self-rating depression scale （SDS） before and after treatment in both groups were evaluated. Moreover, plasma 5-HT and norepinephrine levels were determined. Results The total clinical effective rate in observation group was significantly higher than that in control group [（92.86%） vs （76.19%）] （2 =4.459, P=-0.035）. The HAMD score and SDS score between two groups have no significant differences before treatment （P〉0.05）, and were significantly decreased at the post-treatment 14 d and 30 d （P〈0.05） in both groups. The HAMD score and SDS score in observation group were significantly lower than control group at the post-treatment 14 d and 30 d （P〈0.05）. The plasma 5-HT and norepinephrine levels between two groups showed no significant differences before treamaent （P〉0.05）, and were significantly improved at the post-treatment 14 d and 30 d （P〈0.05）. The plasma 5-HT levels in observation group were significantly higher than control group at the post-treatment 14 dand 30 d, moreover, norepinephrine levels in observation group were significantly lower than control group （P〈0.05）. No obvious adverse reactions occurred during the treatment in both groups. Conclusion The Guipi decoction can improve the clinical efficacy by increasing plasma 5-HT and decreasing norepinephrine levels, which has a positive effect on alleviating the degree of depression and improving the psychological state of patients.