坤泰胶囊联合文拉法辛治疗绝经期抑郁症的疗效观察

Effect of Kuntai Capsule combined with Venlafaxine on menopausal depression

目的探讨应用坤泰胶囊联合文拉法辛治疗绝经期抑郁症的临床效果。方法前瞻性选取2016年8月至2017年2月南平市第一医院收治的64例绝经期抑郁症患者,利用随机数字表法将患者随机分成治疗组(n=32)和对照组(n=32)。对照组口服盐酸文拉法辛缓释片(75～225 mg/次,1次/d)治疗,治疗组在此基础上口服坤泰胶囊(2. 0g/次,3次/d)治疗,所有患者均治疗8周。比较两组临床疗效,治疗前后Kupperman绝经指数(KMI)评分、17项汉密尔顿抑郁量表(HDRS-17)评分、性激素[雌二醇(E2)、卵泡刺激素(FSH)、促黄体生成素(LH)]水平、世界卫生组织生存质量测定简式量表(WHOQOL-BREF)评分变化及不良反应发生情况。结果治疗组总有效率为93. 8%(30/32),较对照组显著上升[75. 0%(24/32),P <0. 05]。与治疗前对比,两组治疗后KMI评分及HDRS-17评分均显著减少(P <0. 05);且治疗组下降更显著(P <0. 05)。治疗组治疗后血清E2水平较治疗前显著上升(P <0. 05),而FSH、LH水平则均显著下降(P <0. 05);但对照组改变不明显(P> 0. 05)。两组治疗后WHOQOL-BREF中各领域(生理、心理、社会关系、环境)评分及总体生存质量、健康状况的主观感受评分较治疗前均显著升高(P <0. 05),且治疗组增高更显著(P <0. 05)。治疗组不良反应率(3. 1%)较对照组(6. 3%),差异无统计学意义(P> 0. 05)。结论应用坤泰胶囊联合文拉法辛治疗绝经期抑郁症可有效改善患者绝经期症状,减轻抑郁障碍,调控机体内分泌,提高生活质量,疗效切实,且安全性较高。

Objective To investigate the clinical effect of Kuntai capsule combined with venlafaxine in the treatment of menopausal depression.Methods 64 menopausal depression patients admitted to our hospital from August 2016 to February 2017 were randomly divided into treatment group(n=32)and control group(n=32).The control group was treated with venlafaxine hydrochloride sustained-release tablets(75~225 mg/time,1 time/d)and the treatment group was treated combined with kuntai capsules(2.0 g/time,3 times/d)on this basis,all patients were treated for 8 weeks.The clinical effects of the two groups were compared,including Kupperman Menopausal Index(KMI)score,17 Hamilton Depression Scale(HDRS-17)score,levels of sex hormones[estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH)]and WHOQOL-BREF score before and after treatment,and the occurrence of side effects.Results The total effective rate of the treatment group was 93.8%(30/32),which was significantly higher than that of the control group[75.0%(24/32),P<0.05].Compared with before treatment,KMI score and HDRS-17 score of the two groups decreased significantly after treatment(P<0.05).And the decrease was more significant in the treatment group(P<0.05).After treatment,the serum E2 level in the treatment group was significantly higher than that before treatment(P<0.05),while the FSH and LH levels were significantly lower(P<0.05).However,there was no significant change in the control group(P>0.05).After treatment,WHOQOL-BREF scores in various fields(physiology,psychology,social relations,environment)and subjective perception scores of overall quality of life and health status in both groups were significantly higher than those before treatment(P<0.05),and the increase in treatment group was more significant(P<0.05).The adverse reaction rate of the treatment group was 3.1%(1/32)higher than that of the control group 6.3%(2/32),and there was no significant difference(P>0.05).Conclusion The application of Kuntai capsule combined with venlafaxine in the treatment of menopausal depression can effectively improve menopausal symptoms,alleviate depressive disorder,regulate endocrine,improve the quality of life,and has practical curative effect and higher safety.