加味逍遥丸联合氟西汀在宫颈癌术后抑郁症患者中的应用效果分析

Efficacy of Jiawei Xiaoyao pill combined with fluoxetine in the treatment of patients with postoperative depression after cervical cancer surgery

目的探讨加味逍遥丸联合氟西汀在宫颈癌术后抑郁症患者中的应用效果。方法根据治疗方法不同将100例宫颈癌术后抑郁症患者分为观察组(n=56)与对照组(n=44),对照组患者口服氟西汀治疗,观察组患者在对照组基础上联合加味逍遥丸口服,均治疗8周。比较两组患者的汉密顿抑郁量表(HAMD)评分、临床疗效、副反应量表(TESS)评分、血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-β(IL-β)、白细胞介素-6(IL-6)]和神经递质[脑源性神经营养因子(BDNF)、多巴胺(DA)、5-羟色胺(5-HT)]水平。结果治疗后,观察组患者的HAMD评分明显低于对照组(P﹤0.01)。观察组的总有效率为87.50%,高于对照组的70.45%(P﹤0.05)。治疗后,两组患者的血清TNF-α、IL-β和IL-6水平均低于本组治疗前,BDNF、DA和5-HT水平均高于本组治疗前,且观察组患者的TNF-α、IL-β和IL-6水平均低于对照组,BDNF、DA和5-HT水平均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的TESS量表中自主神经系统症状评分明显低于对照组,差异有统计学意义(P﹤0.01)。结论加味逍遥丸联合氟西汀治疗宫颈癌术后抑郁症患者,可明显升高BDNF、DA、5-HT水平,降低炎性因子水平,对自主神经系统的影响较小,疗效较好。

Objective To study the efficacy of Jiawei Xiaoyao pill combined with fluoxetine in the treatment of patients with postoperative depression after cervical cancer.and its effect on the levels of brain-derived neurotrophic factor(BDNF),dopamine(DA)and 5-hydroxytryptamine(5-HT).Method According to different treatment methods,100 patients with postoperative depression of cervical cancer were divided into observation group(Jiawei Xiaoyao pill combined with fluoxetine)and control group(fluoxetine alone).All patients were treated for 8 weeks.The effective rate,the score of Hamilton depression scale(HAMD),treatment emergent symptom scale(TESS),the level of inflammatory factors(TNF-α,IL-βand IL-6)and brain-derived neurotrophic factor(BDNF,DA and 5-HT)were compared between the two groups.Result After treatment,the HAMD score of the observation group was significantly lower than that of the control group(P<0.01).The total effective rate of the observation group was 87.50%,higher than that of the control group with 70.45%(P<0.05).After treatment,the serum levels of TNF-α,IL-βand IL-6 in two groups were lower than those before treatment,the serum levels of BDNF,DA and 5-HT in two groups were higher than those before treatment,the serum levels of TNF-α,IL-βand IL-6 in observation group were lower than those of control group,and BDNF,DA and 5-HT levels were higher than those of control group,the differences were statistically significant(P<0.05).The score of autonomic nervous system in the TESS scale was significantly lower than that in the control group(P<0.01).Conclusion Jiawei Xiaoyao pill combined with fluoxetine can significantly increase the levels of BDNF,DA,5-HT and reduce the level of inflammatory factors in patients with depression after cervical cancer operation.It has less side effects on autonomic nervous system,and the overall effect is good,which is worthy of further study.