健脾益肾解郁方联合氟哌噻吨美利曲辛治疗慢性肾脏病抑郁障碍临床观察

Clinical Observation of Jianpi Yishen Jieyu Decoction Combined with Flupentixol and Melitoxine in the Treatment of Depressive Disorder Patients of Chronic Kidney Disease

目的观察健脾益肾解郁方联合氟哌噻吨美利曲辛治疗慢性肾脏病(CKD)抑郁障碍的临床疗效。方法用随机数字表法将60例CKD3~5期(除外慢性肾脏病5期透析患者)合并抑郁障碍患者分为治疗组和对照组,每组各30例。2组均给予CKD的基础治疗。对照组给予基础治疗+氟哌噻吨美利曲辛治疗,治疗组在对照组的基础上加用中药健脾益肾解郁方治疗,疗程2个月。观察2组患者治疗前后中医证候积分、汉密尔顿抑郁量表评分(HAMD)、匹斯堡睡眠指数(PSQI)评分以及相关不良反应的发生情况。结果治疗组和对照组总有效率分别为83.3%、70.0%,2组比较,差异具有统计学意义(P<0.05);2组中医证候积分、HAMD评分、PSQI评分较治疗前下降(P<0.05),组间比较,差异有统计学意义(P<0.05);治疗组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论健脾益肾解郁方联合氟哌噻吨美利曲辛治疗CKD抑郁障碍疗效确切,安全性好。

Objective:To observe the clinical effect of Jianpi Yishen Jieyu Decoction combined with flupentixol and melitroxine in the treatment of depressive disorder patients with chronic kidney disease(CKD).Methods:By using a random number table method,60 patients with CKD stage 3~5(except chronic kidney disease stage 5 dialysis patients)and depression were divided into a treatment group and a control group,30 cases each group.Both groups were given the basic treatment of CKD.The control group was given the basic treatment plus flupentixol and melitroxine treatment and the treatment group was treated with Jianpi Yishen Jieyu Decoction on the basis of the control group,and 2 months was a course of treatment.The scores of TCM syndromes,Hamilton Depression Rating Scale(HAMD),Pittsburgh Sleep Index(PSQI)scores and related adverse reactions were observed before and after treatment in the patients of the two groups.Results:The total effective rates of the treatment group and the control group were 83.3%and 70.0%respectively.The difference between the two groups was statistically significant(P<0.05).The scores of TCM syndromes,HAMD scores,and PSQI scores in the two groups were lower than those of the prior treatment(P<0.05),and the difference between the groups was statistically significant(P<0.05).The incidence of adverse reactions in the treatment group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Jianpi Yishen Jieyu Decoction combined with flupentixol and melitroxine in the treatment of CKD depression is effective and safe.