柴胡加龙骨牡蛎汤治疗糖尿病性便秘合并抑郁症的临床研究

Clinical efficacy of Chaihu plus Longgu Oyster Decoction for diabetic constipation complicated with depression

目的观察柴胡加龙骨牡蛎汤治疗糖尿病性便秘合并抑郁症的临床疗效。方法将60例糖尿病性便秘合并抑郁症患者按照随机数字表法分为2组,对照组30例予西医常规治疗,治疗组30例在对照组治疗基础上加用柴胡加龙骨牡蛎汤治疗。2组均治疗8周后统计疗效,比较2组治疗前后便秘症状(包括粪便性状评分及每周排便次数)、汉密尔顿抑郁量表(HAMD)评分、血糖指标[包括空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA_(1c))]、血脂指标[包括总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]及同型半胱氨酸(Hcy)水平变化情况。结果治疗组总有效率76.7%(23/30),对照组总有效率50.0%(15/30),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后粪便性状评分均升高(P<0.05),每周排便次数均增多(P<0.05),且治疗组治疗后粪便性状评分高于对照组(P<0.05),每周排便次数多于对照组(P<0.05)。与本组治疗前比较,2组治疗后抑郁症状HAMD评分均降低(P<0.05),且治疗组治疗后HAMD评分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血糖指标FPG、2 hPG及HbA_(1c)水平均降低(P<0.05),且治疗组治疗后FPG、2 hPG及HbA_(1c)水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血脂指标TC、TG、LDL-C水平均降低(P<0.05),且治疗组治疗后TC、TG、LDL-C水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血清Hcy水平均降低(P<0.05),且治疗组治疗后血清Hcy水平低于对照组(P<0.05)。结论柴胡加龙骨牡蛎汤治疗糖尿病性便秘合并抑郁症疗效确切,可有效改善患者便秘症状,促进排便,缓解抑郁情绪,调节血糖、血脂代谢,降低Hcy水平,安全可靠。

Objective To observe the clinical efficacy of Chaihu plus Longgu Oyster Decoction for diabetic constipation complicated with depression.Methods A total of 60 patients with diabetic constipation complicated with depression were randomly assigned into the treatment group(n=30)and the control group(n=30).All patients were managed by routine Western medicine,and those in the treatment group were additionally treated with Chaihu plus Longgu Oyster Decoction.Treated for 8 weeks,aiming to compare constipation symptoms(Bristol Stool Scale[BBS]scores,times of weekly defecation),Hamilton Depression Rating Scale(HAMD)score,blood glucose indexes(fasting blood glucose[FBG],2-hour postprandial blood glucose[2 hPG],glycated hemoglobin[HbA_(1c)]),blood lipid indexes(total cholesterol[TC],triglycerides[TG],low-density lipoprotein cholesterol[LDL-C],high-density lipoprotein cholesterol[HDL-C]),homocysteine(Hcy).The curative effect was assessed.Results The overall effective rate in the treatment group was better than that in the control group(76.7%[23/30]vs 50.0%[15/30],[P<0.05],respectively).After treatment,BBS scores,times of weekly defecation in groups were significantly increased(all P<0.05),which increased notably in the treatment group compared with the control group(all P<0.05).HAMD scores in groups were significantly decreased(P<0.05),which were significantly lower in the treatment group than in the control group(P<0.05).FBG,2 hPG and HbA1c in groups were significantly decreased(P<0.05),the reduction in the treatment group was more prevalent compared with the control group(P<0.05).TC,TG,LDL-C in groups were significantly decreased(P<0.05),the decrease in the treatment group was more common than the control group(P<0.05).Compared withbefore treatment,Hcy levels of both groups were significantly decreased after treatment(P<0.05),which in the treatment group weresignificantly lower than those of the control group(P<0.05).Conclusion For patients with diabetic constipation complicated with depression,Chaihu plus Longgu Oyster Decoction has definite curative effect,which can effectively improve constipation symptoms,promote defecation,relieve depression,regulate blood sugar and blood lipid metabolism,and reduce Hcy levels,and with safe and reliable.