柴胡加龙骨牡蛎汤联合西药治疗2型糖尿病合并焦虑抑郁状态疗效及机制研究

Study on Curative Efficacy and Mechanism of Chaihu Jia Longgu Muli Decoction(柴胡加龙骨牡蛎汤)Combined with Western Medicine in Treatment of Type 2 Diabetes Mellitus Complicated with Anxiety and Depression State

目的:观察柴胡加龙骨牡蛎汤治疗少阳证2型糖尿病合并焦虑抑郁状态的临床疗效及对5-羟色胺(5-HT)的影响。方法:将90例少阳证2型糖尿病合并焦虑抑郁状态患者按照随机数字表法分为对照组32例、治疗1组28例和治疗2组30例,三组均予常规降糖治疗,在此基础上,对照组予氟哌噻吨美利曲辛片治疗,治疗1组予柴胡加龙骨牡蛎汤治疗,治疗2组予氟哌噻吨美利曲辛片合柴胡加龙骨牡蛎汤治疗。三组均以2周为1个疗程,共治疗3个疗程。比较三组患者治疗前后中医症状积分、血糖水平、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、血清5-HT水平及安全性指标水平。结果:治疗后,三组患者的中医症状积分、血糖水平、HAMD评分、HAMA评分均较治疗前明显降低(P<0.05),血清5-HT水平均较治疗前升高(P<0.05);治疗1组和治疗2组中医症状积分、餐后2 h血糖水平、HAMD评分、HAMA评分均低于对照组(P<0.05),血清5-HT水平均高于对照组(P<0.05);治疗2组所有指标水平均优于治疗1组(P<0.05)。结论:柴胡加龙骨牡蛎汤联合氟哌噻吨美利曲辛片可明显缓解少阳证2型糖尿病合并焦虑抑郁状态患者的中医症状,改善患者血糖水平及焦虑抑郁状态,其机制可能与调节血清5-HT水平有关。

Objective:To observe the clinical efficacy of Chaihu Jia Longgu Muli Decoction(柴胡加龙骨牡蛎汤)in the treatment of type 2 diabetes mellitus of Shaoyang syndrome complicated with anxiety and depression state and its effect on 5-hydroxytryptamine(5-HT).Methods:A total of 90 patients with type 2 diabetes mellitus of Shaoyang syndrome complicated with anxiety and depression state were divided into control group(32 cases),treatment group 1(28 cases)and treatment group 2(30 cases)by the random number table method.On the basis of conventional glucose-lowering treatment given to all the three groups,the control group was treated with flupentixol and melitracen tablets,the treatment group 1 was treated with Chaihu Jia Longgu Muli Decoction,and the treatment group 2 was treated with flupentixol and melitracen tablets and Chaihu Jia Longgu Muli Decoction.The three groups all took 2 weeks as a course of treatment and were treated for 3 courses of treatment.The traditional Chinese medicine(TCM)symptoms score,blood glucose level,Hamilton depression scale(HAMD)score,Hamilton anxiety scale(HAMA)score,serum 5-HT level,and safety indicator level were compared among the three groups before and after treatment.Results:After treatment,the TCM symptoms score,blood glucose level,HAMD score and HAMA score of the three groups were significantly lower than those before treatment(P<0.05),while the serum 5-HT level of the three groups was significantly higher than that before treatment(P<0.05).The TCM symptoms score,2-hour postprandial blood glucose level,HAMD score and HAMA score of treatment group 1 and treatment group 2 were lower than those of the control group(P<0.05),while the serum 5-HT level in treatment group 1 and treatment group 2 was higher than that in the control group(P<0.05).The levels of all the indicators of treatment group 2 were better than those of treatment group 1.Conclusions:Chaihu Jia Longgu Muli Decoction combined with flupentixol and melitracen tablets can significantly relieve the TCM symptoms of type 2 diabetes mellitus patients of Shaoyang syndrome complicated with anxiety and depression state,and improve the level of blood glucose and the state of anxiety and depression.The mechanism may be related to the regulation of serum 5-HT level.