枣仁安神胶囊联合逍遥散加味治疗老年双相情感障碍临床研究

Clinical Study on Zaoren Anshen Capsules Combined with Modified Xiaoyao Power for Senile Bipolar Disorder

目的:观察枣仁安神胶囊联合逍遥散加味治疗老年双相情感障碍的临床疗效。方法:选取79例老年双相情感障碍患者,按随机数字表法分为中药组39例及联合组40例,中药组使用逍遥散加味治疗,联合组采用枣仁安神胶囊联合逍遥散加味治疗。比较2组临床疗效,比较2组治疗前后抑郁相关指标评分、神经功能[脑源性神经营养因子(BDNF)、5-羟色胺(5-HT)、胰岛素样生长因子-1(IGF-1)]、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-22(IL-22)、白细胞介素-6(IL-6)]水平、氧化应激指标[总胆红素(TBil)、羟基脱氧鸟苷(8-OHdG)、过氧化脂质(LPO)]的变化。结果:治疗后,2组情绪低落、失眠、思维迟缓评分均较治疗前下降,联合组上述3项评分均低于中药组,差异均有统计学意义(P<0.05)。治疗后,2组BDNF、5-HT水平均较治疗前上升,IGF-1水平均较治疗前下降,差异均有统计学意义(P<0.05);治疗后,联合组BDNF、5-HT水平均高于中药组,IGF-1水平低于中药组,差异均有统计学意义(P<0.05)。治疗后,2组TNF-α、IL-22、IL-1水平均较治疗前下降,联合组上述3项水平均低于中药组,差异均有统计学意义(P<0.05)。治疗后,2组TBil指标值均较治疗前上升,8-OHdG、LPO指标值均较治疗前下降,差异均有统计学意义(P<0.05);治疗后,联合组TBil指标值高于中药组,8-OHdG、LPO指标值均低于中药组,差异均有统计学意义(P<0.05)。联合组临床疗效总有效率为95.00%,中药组为79.49%,2组比较,差异有统计学意义(P<0.05)。结论:枣仁安神胶囊联合逍遥散加味治疗老年双相情感障碍,患者抑郁的症状得到缓解,可改善其神经功能水平,有效减轻炎症反应,减轻氧化应激反应程度,有助于病情的恢复。

Objective:To observe the clinical effect of Zaoren Anshen capsules combined with modified Xiaoyao Power for senile bipolar disorder.Methods:A total of 79 cases of senile patients with bipolar disorder were selected and divided into the Chinese medicine group and the combination group according to the random number table method,with 39 and 40 cases in each group respectively.The Chinese medicine group was treated with modified Xiaoyao Power,and the combination group was additionally treated with Zaoren Anshen capsules based on the treatment of the Chinese medicine group.Clinical effects were compared between the two groups.Changes in scores of depression-related indexes,neurological function[brain-derived neurotrophic factors(BDNF),5-hydroxytryptamine(5-HT),insulin-like growth factor-1(IGF-1)],levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-22(IL-22),interleukin-6(IL-6)]and oxidative stress indexes[total bilirubin(TBil),8-Hydroxydeoxyguanosine(8-OHdG),lipid peroxide(LPO)]before and after treatment were compared between the two groups.Results:After treatment,scores of depression,insomnia,and slow thinking in the two groups were decreased when compared with those before treatment,and the above three scores in the combination group were lower than those in the Chinese medicine group,differences being significant(P<0.05).After treatment,levels of BDNF and 5-HT in the two groups were increased when compared with those before treatment,and IGF-1 levels were decreased,differences being significant(P<0.05);levels of BDNF and 5-HT in the combination group were higher than those in the Chinese medicine group,and IGF-1 level was lower,differences being significant(P<0.05).After treatment,levels of TNF-α,IL-22 and IL-1 in the two groups were decreased when compared with those before treatment,and the above three levels in the combination group were lower than those in the Chinese medicine group,differences being significant(P<0.05).After treatment,TBil indexes in the two groups were increased when compared with those before treatment,and the indexes of 8-OHdG and LPO were decreased,differences being significant(P<0.05);TBil index in the combination group was higher than that in the Chinese medicine group,and the indexes of 8-OHdG and LPO were lower,differences being significant(P<0.05).The total clinical effective rate was 95.00%in the combination group,and 79.49%in the Chinese medicine group,the difference being significant(P<0.05).Conclusion:Zaoren Anshen capsules combined with modified Xiaoyao Power for senile bipolar disorder can help relieve the symptom of depression,inflammatory responses,and the degree of oxidative stress response,improve neurological function levels,and conduce to the recovery of patients.