疏利少阳方治疗难治性抑郁症的疗效

Therapeutic effect of Shuli Shaoyang Prescription for refractory depression

目的探讨疏利少阳方对难治性抑郁症的治疗效果及对脑源性神经营养因子(BDNF)和神经递质水平的影响。方法选取本院心理门诊收治的难治性抑郁症患者80例为研究对象,随机分为观察组与对照组,每组40例。对照组给予盐酸帕罗西汀片口服,观察组在此基础上加用疏利少阳方口服治疗,2组均连续治疗8周后观察疗效及不良反应。比较2组治疗前后中医证候积分、汉密顿抑郁量表17项版本(HAMD-17)、汉密尔顿焦虑量表(HAMA)、症状自评量表(SCL-90)评分以及BDNF和神经递质水平的变化。结果治疗后,2组中医证候积分、HAMD-17、HAMA和SCL-90量表评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05);观察组临床总有效率高于对照组,差异有统计学意义(P<0.05)。2组治疗后的5-羟色胺(5-HT)、去甲肾上腺素(NE)、神经肽Y(NPY)水平和BDNF亚型(mBDNF)、BDNF酪氨酸激酶受体B(TrkB)水平均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,2组P物质(SP)和BDNF前体(proBDNF)水平均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率为15.00%,低于对照组的20.00%,差异无统计学意义(P>0.05)。结论疏利少阳方治疗难治性抑郁症的疗效显著,能够改善患者的抑郁、焦虑情绪,可能是通过调节机体BDNF和神经递质水平达到调节情绪的作用。

Objective To investigate the therapeutic effect of Shuli Shaoyang Prescription on refractory depression and its effects on brain-derived neurotrophic factor(BDNF)and neurotransmitter levels.Methods Eighty patients with refractory depression admitted to the psychological outpatient department of our hospital were selected as research objects,and were randomly divided into observation group and control group,with 40 cases in each group.The control group was given paroxetine hydrochloride tablets for oral administration,while the observation group added with Shuli Shaoyang Prescription based on the control group.After continuous treatment for 8 weeks,the efficacy and adverse reactions of the two groups were observed and compared.The scores of TCM syndrome,17-Item Hamilton Rating Scale for Depression(HAMD-17),Hamilton Anxiety Scale(HAMA),Symptom Checklist 90(SCL-90),and the changes in the levels of BDNF and neurotransmitter were compared between the two groups before and after treatment.Results After treatment,the scores of TCM syndrome,HAMD-17,HAMA and SCL-90 of patients in both groups were significantly reduced,and the observation group was significantly lower than those of the control group(P<0.05).The clinical total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the levels of 5-hydroxytryptamine(5-HT),norepinephrine(NE),neuropeptide Y(NPY)and mature BDNF(mBDNF)and tyrosine kinase receptor B of BDNF(TrkB)in the two groups were significantly increased after treatment,and the above indicators in the observation group were significantly higher than those of the control group(P<0.05),while the substance P(SP)and precursor of BDNF(proBDNF)levels were significantly decreased,and they were significantly lower in the observation group than those in the control group(P<0.05).The adverse reactions in the observation group was 15.00%,which was lower than 20.00%in the control group,but there was no statistically significant difference between the two groups(P>0.05).Conclusion Shuli Shaoyang Prescription can significantly enhance curative effect in treatment of refractory depression,improve the patients′emotions such as depression,anxiety.Therefore,emotions may be regulated by regulating the levels of BDNF and neurotransmitters.