解郁安神汤联合常规疗法治疗慢性阻塞性肺疾病合并焦虑抑郁临床研究

Clinical study on Jieyu Anshen decoction combined with conventional therapy for COPD complicated with anxiety and depression

目的观察解郁安神汤联合常规疗法治疗慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并焦虑抑郁的临床疗效。方法选取2021年5月至2022年5月温州市中西医结合医院呼吸与危重症医学科门诊COPD合并焦虑抑郁患者60例,随机分为对照组和观察组,各30例。对照组予氟哌噻吨美利曲辛片联合慢阻肺基础治疗,观察组在对照组的基础上加解郁安神汤治疗。治疗8周后,记录两组临床疗效,比较两组治疗前后焦虑自评量表(self-rating anxiety scale,SAS)评分、抑郁自评量表(self-rating depression scale,SDS)评分、慢性阻塞性肺疾病评估量表(COPD self-assessment test,CAT)评分、肺功能指标[第1秒用力呼气容积/用力肺活量(forced expiratory volume in one second/forced vital capacity,FEV_(1)/FVC)、FEV_(1)%pred]及血清5-羟色胺(5-hydroxytryptamine,5-HT)、多巴胺(dopamine,DA)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平。结果观察组总有效率为96.70%,高于对照组86.70%(P<0.05)。治疗后,两组SAS评分、SDS评分及CAT评分较治疗前下降(P<0.05),且观察组低于对照组(P<0.05);两组FEV_(1)/FVC、FEV_(1)%pred、血清5-HT、DA及BDNF水平较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。结论解郁安神汤联合常规疗法治疗COPD合并焦虑抑郁疗效确切,可以提高血清5-HT、DA及BDNF水平,缓解焦虑抑郁症状,改善肺功能。

Objective To observe the clinical effect of Jieyu Anshen decoction Combined with conventional therapy on chronic obstructive pulmonary disease(COPD)complicated with anxiety and depression.Methods 60 patients with COPD complicated with anxiety and depression were randomly divided into control group and observation group with 30 cases in each group.The control group was treated with Flupentixol and Melitracen tablets,and the observation group was treated with Jieyu Anshen decoction on the basis of the control group.After 8 weeks,the clinical efficacy of the two groups was recorded,and the self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score and COPD self-assessment test(CAT)score,forced expiratory volume in one second/forced vital capacity(FEV_(1)/FVC),FEV_(1)%pred,serum 5-hydroxytryptamine(5-HT),dopamine(DA)and brain-derived neurotrophic factor(BDNF)levels were compared.Results The total effective rate of the observation group(96.70%)was higher than that of the control group(86.70%)(P<0.05).The SAS score,SDS score and CAT score in the two groups decreased after treatment,and the observation group was lower(P<0.05).The levels of FEV_(1)/FVC,FEV_(1)%pred,serum 5-HT,DA and BDNF in the two groups increased after treatment,and the observation group was higher(P<0.05).Conclusions Jieyu Anshen decoction Combined with conventional therapy is effective in the treatment of COPD complicated with anxiety and depression.It can increase the levels of serum 5-HT,DA and BDNF,alleviate the symptoms of anxiety and depression,and improve lung function.