加味甘麦大枣汤联用星状神经节阻滞术治疗双相情感障碍抑郁发作的临床研究

Clinical Study of Modified Ganmai Dazao Decoction Combined with Stellate Ganglion Block in Treatment of Depressive Attack of Bipolar Emotional Disorder

目的观察加味甘麦大枣汤联用星状神经节阻滞术治疗双相情感障碍抑郁发作的临床疗效以及对各项生化指标的影响。方法选取医院2018年1月—2019年5月收治的83例双相情感障碍抑郁发作的患者,随机分为对照组(42例)和观察组(41例),对照组予服丙戊酸钠缓释片,施星状神经节阻滞术,观察组在对照组基础上予服加味甘麦大枣汤,比较两组临床疗效,对比治疗前后汉密顿抑郁量表(HAMD)、蒙哥马利抑郁量表(MADRS)和抑郁自评量表(SDS)评分,观察治疗前后甲状腺激素水平、心肌酶活性、肝功能和血清尿酸水平改变,使用副反应量表(TESS)评价安全性。结果观察组临床总有效率92.7%(38/41),高于对照组64.3%(27/42)(P<0.01),治疗后,观察组HAMD、MADRS和SDS评分改善较对照组更优(P<0.05),治疗后,观察组游离三碘甲腺原氨酸(FT3)、促甲状腺素(TSH)、总胆红素(TBIL)、白蛋白(ALB)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)和尿酸(UA)改善均较对照组更优(P<0.05),不良反应差异无统计学意义(P>0.05)。结论加味甘麦大枣汤联用星状神经节阻滞术疗效显著,能有效改善各项生化指标,缓解抑郁状态。

Objective To observe the clinical efficacy of Modified Ganmai Dazao Decoction combined with stellate ganglion block in the treatment of depressive episodes of bipolar affective disorder and its influence on biochemical indicators.Methods Eighty-three patients with bipolar affective disorder depressive episodes admitted to our hospital from January 2017 to May 2019 were randomly divided into control group(42 cases)and observation group(41 cases).The control group was given valproate sustained-release tablets and stellate ganglion block.The observation group was given Modified Ganmai Dazao Decoction on the basis of the control group.We compared the clinical efficacy of the two groups,the scores of Hamilton Depression Scale(HAMD),Montgomery Depression Scale(MADRS)and Self-Rating Depression Scale(SDS)before and after treatment,and observed the changes of thyroid hormone level,myocardial enzyme activity,liver function and serum uric acid level before and after treatment,and evaluated the safety with the side effects scale(TESS).Results The total clinical effective rate of the observation group was 92.7%(38/41),higher than 64.3%(27/42)of the control group(P<0.01).After treatment,the HAMD,MADRS and SDS scores of the observation group were better than those of the control group(P<0.05).After treatment,the free triiodothyronine(FT3),thyrotropin(TSH)and total bilirubin(TBIL),albumin(ALB),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)and uric acid(UA)of the observation group werebetter than those in the control group(P<0.05),and there was no significant difference in adverse reactions(P>0.05).Conclusion Modified Ganmai Dazao Decoction combined with stellate ganglion block is effective in improving biochemical indexes and alleviating depression.