柴胡疏肝散加减治疗肝气郁结型产后抑郁临床研究

Clinical Study on Modified Bupleurum Liver.Soothing Powder in Treating Postpartum Depression with Liver Qi Stagnation Syndrome

目的:观察柴胡疏肝散加减治疗肝气郁结型产后抑郁的临床疗效。方法:将80例产后抑郁患者按照随机数字表法分为对照组和观察组,每组各40例。对照组给予盐酸氟西汀口服,观察组给予柴胡疏肝散加减治疗。比较两组患者的临床疗效及治疗前后脑神经递质水平[5-羟色胺(5-hydroxytryptamine,5-HT)、脑源性神经营养因子(brain derived neurotrophic factor,BNDF)、去甲肾上腺素(norepinephrine,NA)]、产后抑郁状态积分[爱丁堡产后抑郁量表(edinburgh postpartum depression scale,EPDS)、汉密尔顿抑郁量表(hamilton depression scale,HAMD)]、性激素水平[促黄体生成素(luteotropic hormone,LH)、雌二醇(estradiol,E_(2))、卵泡生成素(follicular stimulating hormone,FSH)]变化情况。结果:观察组有效率高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后HAMD、EPDS积分低于治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者治疗后NA、BDNF、5-HT、FSH、E_(2)、LH水平高于本组治疗前,且治疗后观察组高于对照组(P<0.05)。结论:柴胡疏肝散加减治疗肝气郁结型产后抑郁,可改善患者的临床症状及激素水平,缓解患者焦虑状态,作用机制主要与提高患者脑神经递质表达水平、调节下丘脑-垂体-肾上腺轴神经内分泌系统等有关。

Objective:To observe the clinical eficacy of Modified Bupleurum Liver-Soothing Powder on postpartum depression(PPD)with liver qi stagnation syndrome.Methods:A total of 80 PPD patients were randomly divided into the control group and the observation group according to random number table method,with 40 cases in each group.The control group was given oral administration of Fluoxe-tine Hydrochloride,while the observation group was treated with Modified Bupleurum Liver Soothing Powder.Then the clinical efficacy,the changes of brain neurotransmitter levels[including 5-hydroxytryptamine(5.HT),brain derived neurotrophin(BNDF),norepineph-rine(NA)],postpartum depression status scores[including Edinburgh Postpartum Depression Scale(EPDS),Hamilton Depression Scale(HAMD)],sex hormone levels[including luteotropic hormone(LH),estradiol(E_(2)),follicular stimulating hormone(FSH)]of the two groups before and after treatment were compared.Results:The effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the HAMD and EPDS scores of the two groups were lower than those before treatment,and the observation group's above scores were lower than those of the control group(P<0.05);The levels of NA,BDNF,5-HT,FSH,E_(2),LH in the two groups were higher than those before treatment,and the observation group's above scores were higher than those of the control group(P<0.05).Conclusion:Modified Bupleurum Liver Soothing Powder can improve clinical symptoms and hormone levels in patients with PPD caused by liver qi stagnation,alleviate anxiety,and its mechanism of action is mainly related to increasing the expression level of neurotransmitters in the affected brain,regulating the hypothalamic pituitary adrenal axis neuroendocrine system,and so on.