加味柴胡汤联合帕罗西汀治疗抑郁症疗效及对相关因子影响的研究

Effect of Jiawei Chaihu Decoction and Paroxetine on Serum Levels of IL-2 and TNF-α in Patients with Depression

目的探究加味柴胡汤联合帕罗西汀对抑郁症患者疗效及相关因子的影响。方法选取2017年2月—2018年2月医院收治符合纳入条件抑郁症92例,按照就诊顺序编号随机分为对照组(46例)和研究组(46例)。对照组帕罗西汀治疗,研究组加用加味柴胡汤治疗,均治疗3周。观察两组治疗前、完成治疗后TNF-α、IL-2变化并比较;观察两组治疗前、完成治疗后HAMD各指标变化并比较;观察两组治疗前、完成治疗后神经细胞因子、单胺类递质代谢变化并比较;观察两组治疗前、完成治疗后生活质量指标变化并比较;治疗过程中统计不良反应发生率情况。结果①治疗后两组TNF-α、IL-2较治疗前显著下降(P<0.05),研究组TNF-α、IL-2显著低于对照组(P<0.05)。②治疗后两组认知障碍、睡眠障碍、情绪、躯体性焦虑、精神性焦虑较治疗前均显著降低(P<0.05),治疗后研究组以上指标均显著低于对照组(P<0.05)。③治疗后两组脑源性神经营养因子(BDNF)、神经生长因子(NGF)、5-羟色胺(5-HT)、去甲肾上腺素(NE)较治疗前均显著升高,5-羟吲哚乙酸(5-HIAA)较治疗前均显著下降(P<0.05),治疗后研究组BDNF、NGF、5-HT、NE均显著高于对照组,5-HIAA均显著低于对照组(P<0.05)。④治疗后两组生理功能、情感职能、精神健康、社会功能、生命活力较治疗前均显著升高(P<0.05),完成治疗后研究组以上指标均显著高于对照组(P<0.05)。⑤治疗后研究组口干、便秘、恶心呕吐、头晕头痛、失眠嗜睡、视物模糊、排尿困难不良反应发生率均显著低于对照组(P<0.05)。结论加味柴胡汤辅助帕罗西汀能通过抑制抑郁症炎症反应,改善神经细胞因子和单胺类递质代谢,从而改善症状,且不良反应低。

Objective To explore the effect of Jiawei Chaihu Decoction on interleukin-2(IL-2)and tumor necrosis factor-alpha(TNF-α)in depression.Methods Ninety-two patients with depression who met the inclusion criteria were enrolled in our hospital from February 2017 to February 2018.They were randomly divided into control group(46 cases)and research group(46 cases).The control group was treated with paroxetine and the research group was treated with Jiawei Chaihu Decoction for 3 weeks.The changes of TNF-αand IL-2,the changes of HAMD indexes,the changes of neurocytokines and monoamine transmitters metabolism and the changes of quality of life indexes before and after treatment were observed and compared between the two groups.The incidence rate was recorded.Results After treatment,the levels of TNF-αand IL-2 in the two groups were significantly lower than those before treatment(P<0.05),and the levels of TNF-αand IL-2 in the study group were significantly lower than those in the control group(P<0.05).(2)After treatment,cognitive impairment,sleep disorder,mood,somatic anxiety and mental anxiety in the two groups were significantly lower than those before treatment(P<0.05),and the above indicators in the study group were significantly lower than those in the control group(P<0.05).(3)After treatment,the levels of brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),5-hydroxytryptamine(5-HT),norepinephrine(NE)and 5-hydroxyindole acetic acid(5-HIAA)in the two groups were significantly higher than those before treatment(P<0.05).After treatment,the levels of BDNF,NGF,5-HT and NE in the study group were significantly higher than those in the control group,and the levels of 5-HIAA were significantly lower than those in the control group(P<0.05).(4)After treatment,the physiological function,emotional function,mental health,social function and vitality of the two groups were significantly higher than those before treatment(P<0.05),and the above indexes of the study group were significantly higher than those of the control group(P<0.05).(5)After treatment,the incidence of adverse reactions such as dry mouth,constipation,nausea and vomiting,dizziness and headache,insomnia and sleepiness,blurred vision and dysuria in the study group was significantly lower than that in the control group(P<0.05).Conclusion Jiawei Chaihu Decoction combined with paroxetine can improve the metabolism of neurocytokines and monoamine transmitters by inhibiting the inflammatory response of depression,and thus improving the symptoms with low adverse reactions.