加味芪参二莲汤治疗慢性乙型病毒性肝炎伴抑郁症临床研究

Clinical Study of Modified Qishen Erlian Decoction(加味芪参二莲汤)in Treatment of Chronic Viral Hepatitis B with Depression

目的:探讨加味芪参二莲汤治疗慢性乙型病毒性肝炎伴抑郁症的临床疗效及安全性。方法:将70例慢性乙型病毒性肝炎伴抑郁症患者按随机数字表法分为对照组和观察组各35例。对照组患者采用常规治疗,观察组患者在对照组基础上加用加味芪参二莲汤治疗,两组均连续治疗8周。比较两组患者治疗前后的汉密尔顿抑郁量表(HAMD)评分、生活质量评分、中医证候积分和相关肝功能指标水平,治疗后的抑郁状态疗效,以及治疗期间的不良反应情况。结果:两组患者治疗后的HAMD评分、中医证候积分均明显低于治疗前(P<0.01),生活质量评分均明显高于治疗前(P<0.001),且观察组患者治疗后的HAMD评分、生活质量评分、中医证候积分改善均明显优于对照组(P<0.001)。两组患者治疗后的血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素水平均明显低于治疗前(P<0.001),且观察组患者治疗后的血清ALT、AST、总胆红素水平改善均明显优于对照组(P<0.001)。治疗后,观察组患者抑郁状态总有效率85.71%,对照组患者抑郁状态总有效率62.86%,两组抑郁状态疗效比较,差异有统计学意义(χ2=4.786,P=0.029)。治疗期间,不良反应发生率观察组17.14%,对照组40.00%,两组不良反应情况比较,差异有统计学意义(χ2=4.480,P=0.034)。结论:加味芪参二莲汤治疗慢性乙型病毒性肝炎伴抑郁症临床疗效确切,能够明显改善患者的抑郁状态和肝功能,提高生活质量,且安全性较高。

Objective:To investigate the clinical efficacy and safety of Modified Qishen Erlian Decoction(加味芪参二莲汤)in the treatment of chronic viral hepatitis B with depression.Methods:A total of 70 chronic viral hepatitis B patients with depression were divided into control group and observation group according to the random number table method,with 35 cases in each group.The patients in the control group were treated with conventional treatment,while the patients in the observation group were treated with Modified Qishen Erlian Decoction on the basis of the control group.The patients in the two groups were treated for 8 consecutive weeks.The Hamilton depression scale(HAMD)scores,life quality scores,traditional Chinese medicine(TCM)syndrome scores and related liver function indicators levels of the two groups before and after treatment,the curative efficacy of depression after treatment,and the adverse reactions during treatment were compared.Results:The HAMD scores and TCM syndrome scores of the two groups after treatment were significantly lower than those before treatment(P<0.01),and the life quality scores were significantly higher than those before treatment(P<0.001),and the improvements of HAMD score,life quality score and TCM syndrome scores of the observation group after treatment were significantly better than those of the control group(P<0.001).The levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin of the two groups after treatment were significantly lower than those before treatment(P<0.001),and the improvements of serum ALT,AST,and total bilirubin of the observation group after treatment were significantly better than those of the control group(P<0.001).After treatment,the total effective rate of depression in the observation group was 85.71%,and that in the control group was 62.86%.The difference of curative efficacy of depression between the two groups was statistically significant(χ2=4.786,P=0.029).During the treatment,the incidence of adverse reactions of the observation group was 17.14%,and that of the control group was 40.00%.The difference of adverse reactions between the two groups was statistically significant(χ2=4.480,P=0.034).Conclusions:Modified Qishen Erlian Decoction has definite clinical efficacy in the treatment of chronic viral hepatitis B with depression.It can significantly improve the depression state,liver function,and life quality of the patients,and has a high degree of safety.