疏肝理脾方治疗冠心病经皮冠状动脉介入术术后焦虑抑郁状态疗效研究

Clinical effect study on Shugan Lipi prescription in patients with anxiety and depression statues after PCI for coronary heart disease

目的:研究疏肝理脾方对冠心病经皮冠状动脉介入术(PCI)术后焦虑抑郁状态患者血清脑源性神经营养因子(BDNF)、5-羟色胺(5-HT)水平的影响。方法:按照随机分组原则,将120例冠心病PCI术后焦虑抑郁状态患者分为对照组和观察组各60例,分别给予常规西药、常规西药联合疏肝理脾方治疗,两组均治疗2个月。比较两组临床疗效、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分及血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、髓过氧化物酶(MPO)、脂氧素A4(LXA4)、皮质醇(Cor)、BDNF、5-HT水平。结果:观察组焦虑、抑郁状态的总有效率高于对照组,差异有统计学意义(均P<0.05)。治疗后,两组HAMA评分、HAMD评分及血清hs-CRP、TNF-α、IL-6、LXA4、MPO、Cor均低于治疗前,且观察组低于对照组,差异有统计学意义(均P<0.05)。治疗后,两组血清BDNF、5-HT水平均较治疗前升高,且观察组高于对照组,差异有统计学意义(均P<0.05)。结论:疏肝理脾方治疗冠心病PCI术后焦虑抑郁状态疗效较好,可有效减轻炎症、心理应激反应,上调血清BDNF、5-HT水平,改善焦虑抑郁状态。

Objective:To study effect of Shugan Lipi prescription on serum levels of brain-derived neurotrophic factor(BDNF)and 5-hydroxytryptamine(5-HT)in patients with anxiety and depression statues after percutaneous coronary intervention(PCI).Methods:According to the principle of random grouping,120 patients with anxiety and depression of coronary heart disease after PCI were divided into control group and observation group,60 cases in each group,treated with conventional western medicine and conventional western medicine combined with Shugan Lipi prescription respectively for 2 months.The clinical efficacy,Hamilton anxiety scale(HAMA)score,Hamilton depression scale(HAMD)score,serum high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),myeloperoxidase(MPO),lipoxin A4(LXA4),cortisol(Cor),BDNF and 5-HT levels were compared between the two groups.Results:The total effective rate of anxiety and depression in the observation group were higher than those in the control group(all P<0.05).After treatment,HAMA score,HAMD score and serum levels of hs-CRP,TNF-α,IL-6,LXA4,MPO and Cor in the two groups were decreased compared before treatment,and the observation group were lower than those in the control group,difference statistically significant(all P<0.05).After treatment,the levels of serum BDNF and 5-HT in the two groups were higher than those before treatment,and the levels in the observation group were higher than those in the control group,difference statistically significant(all P<0.05).Conclusion:The treatment of anxiety and depression of coronary heart disease after PCI by Shugan Lipi prescription has significant effect,which can effectively reduce the inflammatory response and psychological stress response,increase the levels of serum BDNF and 5-HT,and improve anxiety and depression.