盐酸米那普仑片联合疏肝解郁胶囊治疗宫颈癌化疗后焦虑抑郁的效果及对淋巴细胞亚群、睡眠和生活质量的影响

Efficacy of Milnacipran Hydrochloride Tablets Combined with Shugan Jieyu Capsules in the Treatment of Anxiety and Depression After Cervical Cancer Chemotherapy and Its Effects on Lymphocyte Subsets,Sleep and Quality of Life

目的:探讨盐酸米那普仑片联合疏肝解郁胶囊治疗宫颈癌化疗后焦虑抑郁的效果及对淋巴细胞亚群、睡眠和生活质量的影响。方法:收集2019年1月至2020年10月新疆维吾尔自治区人民医院收治的宫颈癌化疗后焦虑抑郁患者80例,采用随机数字表法分为对照组和观察组,每组40例。在常规心理干预措施基础上,对照组患者采用疏肝解郁胶囊治疗,观察组患者采用盐酸米那普仑片联合疏肝解郁胶囊治疗。采用焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)和生活质量(quality of life,QOL)评分评价两组患者的焦虑、抑郁状况、睡眠质量及生活质量,观察两组患者血清5-羟色胺(5-HT)、去甲肾上腺素(NE)、T淋巴细胞亚群水平和不良反应发生情况。结果:治疗后,观察组患者的SAS评分、SDS评分明显低于对照组,血清5-HT、NE水平明显高于对照组,差异均有统计学意义(P <0.05)。T淋巴细胞亚群水平检测结果显示,观察组患者治疗后的CD4^(+)、CD4^(+)/CD8^(+)水平明显高于对照组,CD8^(+)水平明显低于对照组,差异均有统计学意义(P <0.05)。观察组患者治疗后的PSQI评分明显低于对照组,QOL评分明显高于对照组,差异均有统计学意义(P <0.05)。观察组、对照组患者的不良反应发生率分别为30.0%(12/40)、20.0%(8/40),两组的差异无统计学意义(χ^(2)=1.07,P=0.30)。结论:盐酸米那普仑片联合疏肝解郁胶囊治疗宫颈癌化疗后焦虑抑郁具有较好的有效性和安全性,能够缓解患者焦虑抑郁情绪,改善机体细胞免疫功能,并提高患者睡眠质量和生活质量。

OBJECTIVE: To probe into the efficacy of Milnacipran hydrochloride tablets combined with Shugan Jieyu capsules in the treatment of anxiety and depression after cervical cancer chemotherapy and its effects on lymphocyte subsets,sleep and quality of life. METHODS: Totally 80 patients with anxiety and depression after cervical cancer chemotherapy admitted into People’s Hospital of Xinjiang Uygur Autonomous Region from Jan. 2019 to Oct. 2020 were extracted to be divided into the control group and the observation group via the random number table,with 40 cases in each group. On the basis of the conventional psychological interventions,the control group was treated with Shugan Jieyu capsules,while the observation group received Milnacipran hydrochloride tablets combined with Shugan Jieyu capsules. Self-rating anxiety scale( SAS),self-rating depression scale( SDS),Pittsburgh sleep quality index( PSQI) and quality of life( QOL) were used to evaluate the anxiety,depression,sleep and life quality in two groups. The serum levels of 5-hydroxytryptamine( 5-HT) and norepinephrine( NE),T lymphocyte subsets and the incidence of adverse drug reactions were observed in both groups. RESULTS: After treatment,the SAS score and SDS score of the observation group were significantly lower than those of the control group,and the serum levels of 5-HT and NE were significantly higher than those of the control group,with statistically significant differences( P < 0. 05).The detection results of T lymphocyte subsets showed that the levels of CD4^(+)and CD4^(+)/CD8^(+)in the observation group were significantly higher than those in the control group after treatment, and the levels of CD8^(+)were significantly lower than those in the control group,the differences were statistically significant( P < 0. 05). The PSQI score of the observation group after treatment was significantly lower than that of the control group,and the QOL score was significantly higher than that of the control group,with statistically significant differences( P < 0. 05). The incidences of adverse drug reactions in the observation group and control group were respectively 30. 0%( 12/40) and 20. 0%( 8/40), and the difference was not statistically significant( χ^(2)= 1. 07, P = 0. 30). CONCLUSIONS:Milnacipran hydrochloride tablets combined with Shugan Jieyu capsules in the treatment of anxiety and depression after cervical cancer chemotherapy is significant with higher safety,which can relieve the anxiety and depression in patients,improve the cellular immune function,and promote the quality of sleep and life.