顺气解郁汤对产妇产后抑郁及雌二醇、孕酮及5-羟色胺水平的影响

Effects of Shunqi Jieyu Decoction on postpartum depression and levels of estradiol,progesterone,and 5-hydroxytryptamine in puerperae

目的观察顺气解郁汤在产后抑郁(PPD)中的应用效果,并探讨其对血清雌二醇(E2)、孕酮(P)以及5-羟色胺(5-HT)水平的影响。方法选取2016年1月至2019年1月西安市第一医院收治的76例PPD患者为研究对象,采用随机数表法分为观察组和对照组,每组38例。对照组患者应用西药帕罗西汀治疗,观察组患者在对照组治疗的基础上联合使用顺气解郁汤治疗,两组均治疗8周。治疗前后采用汉密尔顿抑郁量表(HAMD)评估患者病情,抽取空腹静脉血检测血清E2、P和5-HT水平;治疗结束后比较两组临床疗效,随访患者复发情况。结果治疗后,观察组患者的治疗总有效率为92.11%,明显高于对照组的71.05%,差异有统计学意义(P<0.05);治疗后,观察组患者的HAMD评分为(8.23±1.57)分,明显低于对照组的(12.15±2.08)分,HAMD减分率为(54.71±7.20)%,明显高于对照组的(38.84±5.83)%,差异均有统计学意义(P<0.05);治疗后,观察组和对照组患者的E2[(206.41±21.95)pg/mL vs(175.52±16.80)pg/mL]、5-HT[(608.82±70.75)ng/mL vs(545.70±62.70)ng/mL]比较,观察组明显高于对照组,差异均有统计学意义(P<0.05);治疗后,观察组患者的P水平为(20.16±3.15)ng/mL,明显低于对照组的(37.83±4.01)ng/mL,差异有统计学意义(P<0.05);治疗结束后6个月时,观察组患者的PDD复发率为7.89%,明显低于对照组的26.32%,差异有统计学意义(P<0.05)。结论顺气解郁汤联合西药治疗PPD能显著提高临床疗效,降低HAMD评分和复发率,其机制可能与调节性激素和神经递质水平有关。

Objective To observe the application effect of Shunqi Jieyu Decoction in postpartum depression(PPD),and to explore its effects on levels of serum estradiol(E2),progesterone(P)and 5-hydroxytryptamine(5-HT).Methods A total of 76 PPD patients who were admitted to Department of Obstetrics and Gynecology,the First Hospital of Xi'an City during the period from January 2016 to January 2019 were enrolled as study objects.They were divided into observation group and control group by random number table method,with 38 patients in each group.The control group was treated with western medicine paroxetine,while observation group was treated with Shunqi Jieyu Decoction on basis of control group.Both groups were treated for 8 weeks.Before and after treatment,conditions of patients were evaluated by Hamilton Depression Scale(HAMD).The fasting venous blood was collected to measure the levels of serum E2,P,and 5-HT.At end of treatment,the clinical curative effect was compared between the two groups,and recurrence situations were followed up.Results After treatment,the total response rate of treatment in observation group was significantly higher than that in control group(92.11%vs 71.05%,P<0.05).HAMD score in observation group was significantly lower than that in control group:(8.23±1.57)points vs(12.15±2.08)points,P<0.05.The decrease rate of HAMD in observation group was significantly higher than that in control group:(54.71±7.20)%vs(38.84±5.83)%,P<0.05.After treatment,levels of E2 and 5-HT in observation group were significantly higher than those in control group:(206.41±21.95)pg/mL vs(175.52±16.80)pg/mL,P<0.05;(608.82±70.75)ng/mL vs(545.70±62.70)ng/mL,P<0.05;while P level was significantly lower than that in control group:(20.16±3.15)ng/mL vs(37.83±4.01)ng/mL,P<0.05.At 6 months after treatment,PDD recurrence rate in observation group was significantly lower than that in control group(7.89%vs 26.32%,P<0.05).Conclusion Shunqi Jieyu Decoction combined with western medicine can significantly improve the clinical curative effect on PPD,reduce HAMD score and recurrence rate.The mechanism may be related to regulating the levels of sex hormones and neurotransmitters.