舒肝解郁胶囊联合氟哌噻吨美利曲辛片治疗神经衰弱肝郁脾虚证临床研究

Clinical Study on Shugan Jieyu Capsules Combined with Flupentixol and Melitracen Tablets for Neurasthenia with Liver Depression and Spleen Deficiency Syndrome

目的:观察舒肝解郁胶囊联合氟哌噻吨美利曲辛片治疗神经衰弱肝郁脾虚证的疗效以及对血清多巴胺(DA)和5-羟色胺(5-HT)水平的影响。方法:纳入66例神经衰弱肝郁脾虚证患者,随机分为对照组和治疗组。2组患者均接受氟哌噻吨美利曲辛片治疗,治疗组加予舒肝解郁胶囊治疗。2组均连续治疗12周。比较2组治疗前及治疗12周后的90项症状自评量表(SCL-90)评分、汉密尔顿抑郁量表(HAMD-17)评分、肝郁脾虚证症状评分及血清DA、5-HT水平,比较2组的临床疗效。结果:治疗后,治疗组临床疗效总有效率93.94%,对照组总有效率69.70%,2组比较,差异有统计学意义(P<0.05)。2组SCL-90评分及HAMD-17评分均较治疗前降低(P<0.01),治疗组2项评分均低于对照组(P<0.01)。2组肝郁脾虚证症状评分均较治疗前降低(P<0.01),治疗组肝郁脾虚证症状评分低于对照组(P<0.01)。2组血清DA水平均较治疗前升高,5-HT水平均较治疗前降低(P<0.01),差异均有统计学意义,治疗组血清DA水平高于对照组,5-HT水平均低于对照组,差异均有统计学意义(P<0.01)。结论:舒肝解郁胶囊联合氟哌噻吨美利曲辛片治疗神经衰弱肝郁脾虚证效果显著,有助于改善患者的精神症状、抑郁症状以及中医证候,该疗法可能通过调节DA、5-HT水平,对神经衰弱发挥治疗作用。

Objective:To observe the clinical effect of Shugan Jieyu capsules combined with flupentixol and melitracen tablets for neurasthenia with liver depression and spleen deficiency syndrome and its effects on the levels of dopamine(DA)and 5-hydroxytryptamine(5-HT)in serum.Methods:A total of 66 cases of patients with neurasthenia with liver depression and spleen deficiency syndrome were randomly divided into the control group and the treatment group.Both groups were treated with flupentixol and melitracen tablets,and the treatment group was additionally treated with Shugan Jieyu capsules.Both groups were treated for 12 weeks.Before treatment and after 12 weeks of treatment,the scores of Symptom Checklist90(SCL-90)and Hamilton Depression Rating Scale(HAMD-17),the symptom scores of liver depression and spleen deficiency syndrome and the levels of DA and 5-HT in serum in the two groups were compared.The clinical effects in the two groups were compared.Results:After treatment,the total effective rate of clinical effect was 93.94%in the treatment group and 69.70%in the control group,the difference being significant(P<0.05).The scores of SCL-90 and HAMD-17 in the two groups were decreased when compared with those before treatment(P<0.01),and the above two scores in the treatment group were lower than those in the control group(P<0.01).The symptom scores of liver depression and spleen deficiency syndrome in the two groups were decreased when compared with those before treatment(P<0.01),and the symptom score in the treatment group was lower than that in the control group(P<0.01).The levels of DA in serum in the two groups were increased when compared with those before treatment(P<0.01),and the levels of 5-HT in serum were decreased(P<0.01).And the inprovement of the above levels in the treatment group were significant than those in the control group(P<0.01).Conclusion:The therapy of Shugan Jieyu capsules combined with flupentixol and melitracen tablets for neurasthenia with liver depression and spleen deficiency syndrome has a significant effect,and can help to improve the mental symptoms,depression and Chinese medicine syndromes of patients.This therapy can play a therapeutic role in neurasthenia by regulating the levels of DA and 5-HT.