复方柴金解郁片治疗抑郁症的效果及对血清炎症因子和神经递质的影响

Effect of Compound Chaijin Jieyu Tablets in the treatment of depression and its influence on serum inflammatory factors and neurotransmitters

目的探讨复方柴金解郁片治疗抑郁症的效果及对血清炎症因子和单胺神经递质的影响。方法选取2018年5月—2019年12月湖南中医药大学第一附属医院神经内科门诊收治的抑郁症患者80例,将其按照随机数字表法分为观察组和对照组,每组各40例,治疗8周。观察组采用中药复方自制剂柴金解郁片治疗,对照组采用西药盐酸舍曲林片治疗,比较两组治疗4、8周后的临床疗效及中医证候疗效。治疗8周后,比较两组血清单胺神经递质(5-羟色胺、去甲肾上腺素、多巴胺)和炎症因子(肿瘤坏死因子-α、白细胞介素-6、白细胞介素-2)的水平。观察两组药物安全性。结果治疗过程中,观察组脱落3例,对照组脱落2例。治疗4周后,两组临床疗效和中医证候疗效比较差异无统计学意义(P>0.05)。治疗8周后,两组临床疗效比较差异无统计学意义(P>0.05),但观察组中医证候总有效率高于对照组,差异有统计学意义(P<0.05)。治疗8周后,两组各单胺神经递质水平均高于治疗前,各炎症因子水平均低于治疗前,差异均有统计学意义(均P<0.05);但两组单胺神经递质水平和炎症因子水平比较,差异无统计学意义(P>0.05)。两组患者治疗前、治疗8周后肝肾功能、心肌酶、三大常规化验及心电图检查均未发现明显异常变化。结论复方柴金解郁片治疗肝郁脾虚证抑郁症效果肯定,安全性较高,适合在临床推广应用。

Objective To explore the effect of Compound Chaijin Jieyu Tablets in treating depression and its influence on serum inflammatory factors and monoamine neurotransmitters.Methods A total of 80 patients with depression admitted to the Department of Neurology,the First Affiliated Hospital of Hu’nan University of Chinese Medicine from May 2018 to December 2019 were selected.All observed cases were divided into observation group and control group according to the random number table method,with 40 cases in each group.The course of treatment was eight weeks.The observation group was treated with self-prepared Compound Chaijin Jieyu Tablets,and the control group was treated with Western medicine Hydrochloride Sertraline Tablets.The clinical efficacy and traditional Chinese medicine(TCM)syndromes efficacy were compared between the two groups after four and eight weeks of treatment.The levels of serum monoamine neurotransmitters(5-hydroxytryptamine,norepinephrine,dopamine)and inflammatory factors(tumor necrosis factor-α,inter leukin-6,interleukin-2)were compared between the two groups after eight weeks of treatment.The safety of the two groups was observed.Results During the treatment,two patients in the control group and three patients in the observation group fell off.After four weeks of treatment,there was no significant difference in clinical efficacy and TCM syndrome efficacy between the two groups(P>0.05).After eight weeks of treatment,there was no statistically significant difference in clinical efficacy between the two groups(P>0.05),but the total effective rate of TCM syndromes in the observation group was higher than that in the control group,with statistically significant difference(P<0.05).After eight weeks of treatment,the levels of monoamine neurotransmitters were higher than those before the treatment,and the levels of inflammatory factors were lower than those before the treatment,with statistical significant differences(all P<0.05).But there was no statistical significance in serum levels of inflammatory factors and neurotransmitters between groups(P>0.05).The patients’liver and kidney function,myocardial enzymes,three routine tests,and electrocardiogram examination before and after treatment were not found any obvious abnormal changes.Conclusion The Compound Chaijin Jieyu Tablet has a positive effect on the treatment of depression with liver depression and spleen deficiency,and has high safety,which is suitable for clinical application.