圣约翰草提取物治疗伴高同型半胱氨酸血症的2型糖尿病并脑出血后抑郁患者的疗效观察

The efficacy of St. John’s wort extract on the treatment of depression in patients with type 2 diabetes mellitus complicated with hyperhomocysteinemia and post-cerebral hemorrhage

目的 :观察圣约翰草提取物治疗伴高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)的2型糖尿病合并脑出血后抑郁症患者的临床疗效。方法:对400例2型糖尿病合并脑出血患者应用汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分,选取其中存在抑郁状态且空腹血浆同型半胱氨酸(homocysteine,Hcy)>20μmol/L的患者60例,分为治疗组(30例)、对照组(30例)。对照组脑出血常规治疗,同时给予叶酸、甲钴胺、维生素B6;治疗组在对照组治疗的基础上,给予圣约翰草提取物,总疗程12周,比较治疗前后HAMD的评分和神经功能缺损评分(neurological deficency score,NDS)。结果:在第6、12周HAMD评分治疗组分别为(14.60±6.18)分、(9.33±5.53)分,较对照组(23.27±3.87)分、(23.00±4.13)分明显下降,差异有统计学意义(P<0.01)。在第12周NDS治疗组为(16.40±4.82)分,较对照组(22.43±3.17)分明显下降,差异有统计学意义(P<0.01)。结论:对HHcy的脑出血后抑郁患者应用叶酸、甲钴胺、维生素B6联合圣约翰草提取物治疗疗效较好,并且能改善神经功能缺损程度。

Objective To evaluate the efficacy of St. John’s wort extract in the treatment of depression in patients with type 2 diabetes mellitus complicated with hyperhomocysteinemia(HHcy) with post-cerebral hemorrhage. Methods A total of 400 patients with type 2 diabetes mellitus complicated with cerebral hemorrhage were screened with Hamilton depression scale(HAMD) and 60 patients with depression and fasting plasma homocysteine(Hcy) >20 μmol/L were divided into the treatment group(30 cases) and the control group(30 cases). The control group was treated with folic acid,mecobalamin and vitamin B6 and patients in treatment group were also given St. John’s wort extract for 12 weeks. The treatment outcome was determined by comparing HAMD score and the neurological deficit disorder(NDS) score before and after treatment. Results In the 6 th and 12 th week, the HAMD scores were significantly lower in the treatment group(14.60±6.18, 9.33±5.53) than in the control group(23.27±3.87, 23.00±4.13)(P<0.01). In the 12 th week, the NDS score was significantly lower in the treatment group(16.40±4.82) than in the control group(22.43±3.17)(P<0.01). Conclusions For patients with post-cerebral HHcy, combination of folic acid, mecobalamin, vitamin B6 and St. John’s wort can improve the depression and neurological deficit.