柴胡加龙骨牡蛎汤加减联合西药治疗产后抑郁患者的疗效及对NE、5-HT的影响

Clinical Effect of Using Caihu Adding Longgu Muli Decoction Combined with Western Medicine in the Treatment of Postpartum Depression Patients and Its Inflence on NE,5-HT

目的:观察柴胡加龙骨牡蛎汤加减联合帕罗西汀对产后抑郁患者的疗效及5-HT的影响。方法:将我院2018年1月至2019年9月产后抑郁患者68例,随机分为两组,各34例,对照组采用帕罗西汀治疗;观察组采用帕罗西汀联合柴胡加龙骨牡蛎汤加减治疗。治疗前、治疗2周和治疗4周时记录患者去甲肾上腺素(Norepinephrine, NE)、5-羟色胺(5-hydroxytryptamine, 5-HT)、多巴胺(dopamine, DA)及Hamilton汉密尔顿抑郁量表(Hamilton Depression Scale, HAMD)、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index, PSQI)、健康调查简表(the MOS item short from health survey, SF-36),比较临床疗效及不良反应。结果:对照组有效率76.47%低于观察组94.12%,差异有统计学意义(P<0.05)。与治疗前比,两组治疗2周、治疗4周时血NE、5-HT、DA水平升高;与对照组比,观察组治疗2周、治疗4周时血NE、5-HT、DA水平较高,差异有统计学意义(P<0.05)。与治疗前比,两组治疗2周、治疗4周时HAMD量表、PSQI量表降低,SF-36评分升高;与对照组比,观察组治疗2周、治疗4周时HAMD量表、PSQI量表较低,SF-36评分较高,差异有统计学意义(P<0.05)。治疗期间两组患者无不良反应出现。结论:柴胡加龙骨牡蛎汤加减联合帕罗西汀对产后抑郁患者的疗效确切,可以改善抑郁症状,提高睡眠和生活质量,与提高神经递质有关,值得推广。

Objective: To explore the clinical effect of Caihu Adding Longgu Muli Decoction combined with Paroxetine for postpartum depression patients on levels of 5-HT. Methods: 68 patients with postpartum depression from January 2018 to September 2019 in our hospital were randomly divided into two groups, 34 in each group. The controlled group received Paroxetine, and the observation group received more with Caihu Adding Longgu Muli Decoction. Levels of Norepinephrine(NE),5-hydroxytryptamine(5-HT),dopamine(DA),Hamilton Depression Scale(HAMD),Pittsburgh sleep quality index(PSQI),the MOS item short from health survey(SF-36) were recorded before, 2 weeks and 4 weeks after treatment, and the clinical efficacy and adverse reactions were also compared. Results: The effective rate of the controlled group(76.47%) was lower than the observation group(94.12%),(P<0.05). Compared with before treatment, the levels of NE,5-HT and DA in the blood of the two groups increased at 2 weeks and 4 weeks of treatment, compared with the controlled group, the levels of NE,5-HT and DA in the blood of the observation group were higher at 2 weeks and 4 weeks of treatment(P<0.05). Compared with the before treatment, the HAMD scale and PSQI scale decreased and SF-36 score increased in the two groups at 2 weeks and 4 weeks of treatment, compared with the controlled group, the HAMD scale and PSQI scale were lower and SF-36 score were higher in the observation group at 2 weeks and 4 weeks of treatment(P<0.05). During the treatment, there were no adverse reactions in the two groups. Conclusion: The therapeutic effect of Caihu Adding Longgu Muli Decoction combined with Paroxetineon for postpartum depression patients is definite. It can improve depressive symptoms, sleep and quality of life. It is related to the improvement of neurotransmitters and is worth popularizing.