中药联合文拉法辛治疗抑郁症的疗效观察

Comparative study of the clinical efficacy of Chinese herbal medicines combined with venlafaxine against depression

目的观察中医从肾论治联合文拉法辛治疗抑郁症的疗效。方法将68例抑郁症病人随机分为观察组和对照组,观察8周,随访1年。对照组采用文拉法辛治疗,观察组采用中药联合文拉法辛治疗。在治疗第0、1、2、4、8周进行汉密尔顿抑郁量表(HAMD)及副反应量表(TESS)评定,检测治疗后两组文拉法辛药物浓度,并比较1年后的复发率。结果观察组总有效率为88.24%,对照组总有效率为64.71%,观察组明显高于对照组(χ2=5.231,P<0.05)。观察组治疗各期HAMD评分、TESS评分均显著低于对照组,两组比较,差异有统计学意义(P<0.05或P<0.01)。观察组显效剂量、维持剂量均明显低于对照组,两组比较,差异有统计学意义(P<0.01)。两组文拉法辛药物浓度比较,差异无统计学意义(P>0.05)。结论中医从肾论治对文拉法辛治疗抑郁症有增效作用,且起效时间快,不良反应少,维持剂量低。

Objective To observe the efficacy of traditional Chinese medicine(TCM)treatment from kidney combined with venlafaxine against depression.Methods A total of 68 patients with depression were randomly divided into the observation group and the control group,observed for 8 weeks and followed up 1 year later.The control group was treated with venlafaxine,while the observation group was treated with Chinese herbal medicines combined with venlafaxine.The Hamilton depression scale(HAMD)and treatment emergent symptom scale(TESS)were used for evaluation at week 0,1,2,4,8 of treatment,the drug concentration of venlafaxine in the two groups after treatment was detected,and the relapse rate 1 year later was compared.Results The total effective rate of the observation group was 88.24%,and that of the control group was 64.71%,so that of the observation group was significantly superior to that of the control group(χ2=5.231,P<0.05).The HAMD scores and TESS scores of the observation group were all significantly lower than those of the control group in each stage of treatment,and the differences between the two groups were statistically significant(P<0.05 or P<0.01).The effective dose and maintenance dose of the observation group were both significantly lower than those of the control group,and the comparison between the two groups was statistically significant(P<0.01).There was no significant difference in the drug concentration of venlafaxine between the two groups(P>0.05).Conclusion The TCM treatment from kidney has synergism when combined with venlafaxine against depression.The therapy takes effect quickly with few adverse reactions(ADRs)and requires low maintenance dose.