舒乳解郁汤联合穴位贴敷治疗乳腺癌术后抑郁失眠临床疗效观察

Clinical Observation on Shuru Jieyu Tang and Acupoint Application in the Treatment of Postoperative Depression and Insomnia of Breast Cancer

目的:对舒乳解郁汤联合中药穴位贴敷治疗乳腺癌术后抑郁失眠进行临床观察。方法:选取乳腺癌术后抑郁患者137例,分为观察组(68例)与对照组(69例)。对照组予常规西医治疗方案治疗,观察组在此基础上联合舒乳解郁汤及穴位贴敷治疗,连续干预6周。评价工具为匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)量表、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD),同时比较两组临床疗效及血清P物质(Substance P,SP)、血清5羟色胺(5-hydroxytryptamine,5-HT)、神经肽Y(neuropeptide Y,NPY)水平,并进行安全性评价。结果:PSQI评分、HAMD评分治疗后两组均显著低于治疗前(P<0.01),且观察组下降幅度大于对照组(P<0.05)。治疗后血清SP水平观察组明显低于对照组(P<0.01),5-HT、NPY水平观察组明显高于对照组(P<0.01)。观察组总有效率[92.65%(63/68)]高于对照组[83.82%(57/68)](P<0.01)。观察组不良反应发生率[10.29%(7/68)]低于对照组[30.43%(21/69)](P<0.01)。结论:舒乳解郁汤联合穴位贴敷治疗乳腺癌术后抑郁失眠安全有效,能够显著提升患者的睡眠质量和生活质量。

Objective:To observe clinical effects of Shuru Jieyu Tang and herbal acupoint application in the treatment of postoperative depression and insomnia of breast cancer.Methods:All 137 patients were randomized into the observation group(68 cases)and the control group(69 cases).The control group was treated by routine therapeutic regimen of Western medicine,and the observation group Shuru Jieyu Tang and herbal acupoint application,for six weeks consecutively.The evaluation tools were Pittsburgh sleep quality index and Hamilton Depression Scale(HAMD),simultaneously to compare clinical effects,the levels of SP,5-HT and NPY between both groups,and to carry out the safety assessment.Results:After the treatment,PSQI and HAMD scores were noticeably lower than these before the treatment(P<0.01),and the decrease of the observation group was greater than that of the control group(P<0.05).After the treatment,the levels of serum SP in the observation group were remarkably lower than these of the control group(P<0.01),the observation group was obviously higher than the control group in the levels of 5-HT and NPY(P<0.01).Total effective rate of the observation group was[92.65%(63/68)],higher than[83.82%(57/68)]of the control group(P<0.01).The incidence of adverse reaction of the observation group was[10.29%(7/68)],lower than[30.43%(21/69)]of the control group(P<0.01).Conclusion:Shuru Jieyu Tang and herbal acupoint application is safe and effective in the treatment of postoperative depression and insomnia of breast cancer,which could noticeably improve the patients'sleep quality and quality of life.