宁心安神胶囊联合文拉法辛治疗广泛性焦虑症的临床研究

Clinical study on Ningxin Anshen Capsules combined with venlafaxine in treatment of generalized anxiety disorder

目的探讨宁心安神胶囊联合文拉法辛治疗广泛性焦虑症的临床疗效。方法选取2017年1月—2017年12月在中国人民解放军陆军军医大学第一附属医院治疗的广泛性焦虑症患者140例,根据用药差别分为对照组(70例)和治疗组(70例)。对照组口服盐酸文拉法辛缓释胶囊,起始剂量75 mg/d,1次/d,必要时可递增至最大剂量225 mg/d;治疗组在对照组基础上口服宁心安神胶囊,4粒/次,3次d。两组均治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状评分、汉密尔顿焦虑量表(HAMA)、焦虑自评量表(SAS)、匹兹堡睡眠质量指数量表(PSQI)和健康调查简表(SF-36)评分及神经递质水平。结果治疗后,对照组临床有效率为80.00%,显著低于治疗组的94.29%,两组比较差异有统计学意义(P<0.05)。治疗后,两组恐惧惊剔、心烦易怒、心悸和失眠多梦症状积分均显著降低(P<0.05),且治疗后治疗组临床症状评分明显低于对照组(P<0.05)。治疗后,两组HAMA、SAS和PSQI评分显著降低(P<0.05),SF-36评分显著升高(P<0.05),且治疗后治疗组HAMA、SAS、PSQI和SF-36量表评分明显优于对照组(P<0.05)。治疗后,两组患者血清5-羟色胺(5-HT)、去甲肾上腺素(NE)和多巴胺(DA)水平均显著降低(P<0.05),且治疗组血清5-HT、NE和DA水平明显低于对照组(P<0.05)。结论宁心安神胶囊联合文拉法辛治疗广泛性焦虑症可有效改善患者临床症状,提高患者睡眠和生活质量,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Ningxin Anshen Capsules combined with venlafaxine in treatment of generalized anxiety disorder. Methods Patients（140 cases） with generalized anxiety disorder in the First Hospital Affiliated of AMU of PLA from January 2017 to December 2017 were divided into control（70 cases） and treatment（70 cases） groups according to different treatments. Patients in the control group were po administered with Venlafaxine Hydrochloride Sustained-Release Capsules, and the initial dose was 75 mg/d, once daily, and increased to maximum dose of 225 mg/d if it was necessary. Patients in the treatment group were po administered with Ningxin Anshen Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the clinical symptom scores, the HAMA, SAS, PSQI, and SF-36 scores, the neurotransmitter levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.00%, which was significantly lower than 94.29% in the treatment group, and there were differences between two groups（P〈0.05）. After treatment, the symptom scores of fear, annoyed and irritable, palpitate and insomnia, and dreamful sleep in two groups were significantly decreased（P〈0.05）, and the clinical symptom scores in the treatment group were significantly lower than those in the control group（P〈0.05）. After treatment, the HAMA, SAS and PSQI scores in two groups were significantly decreased（P〈0.05）, but SF-36 scores were significantly increased（P〈0.05）, and the HAMA, SAS, PSQI and SF-36 scores in the treatment group were significantly better than those in the control group（P〈0.05）. After treatment, the 5-HT, NE and DA levels in two groups were significantly decreased（P〈0.05）, and the 5-HT, NE and DA levels in the treatment group were significantly lower than those in the control group（P〈0.05）. Conclusion Ningxin Anshen Capsules combined with venlafaxine in treatment of generalized anxiety disorder can effectively improve the clinical symptoms, sleep and quality of life, which has a certain clinical application value.