小柴胡汤联合重复经颅磁刺激、盐酸度洛西汀治疗女性躯体形式障碍临床研究

Clinical study on Small Bupleurum Decoction combined with repetitive transcranial magnetic stimulation and duloxetine hydrochloride in the treatment of female somatoform disorders

目的:观察小柴胡汤联合重复经颅磁刺激、盐酸度洛西汀治疗女性躯体形式障碍的效果及安全性。方法:选取女性躯体形式障碍患者90例,将其随机分为三组:对照1组、对照2组、观察组,每组30例。对照1组给予盐酸度洛西汀胶囊治疗,对照2组在盐酸度洛西汀胶囊治疗的基础上结合重复经颅磁刺激治疗,观察组在对照2组治疗的基础上加用小柴胡汤治疗,三组患者均连续治疗8周。观察各组精神症状自评量表(SCL-90)评分、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、中医证候积分评分和血清5-羟色胺(5-HT)、去甲肾上腺素(NE)、雌二醇(E_(2))水平变化及不良事件。结果:治疗8周后,观察组患者SCL-90、HAMD、HAMA评分、中医证候积分低于对照1组和对照2组(P<0.05)。治疗8周后,三组患者的血清5-HT、NE、E_(2)水平均比治疗前、治疗4周后有所上升,对照2组患者的5-HT、NE、E_(2)水平高于对照1组(P<0.05),观察组患者的5-HT、NE、E_(2)水平高于对照2组(P<0.05)。结论:小柴胡汤联合重复经颅磁刺激、盐酸度洛西汀治疗可改善女性躯体形式障碍患者的躯体症状,疗效良好。

Objective:To observe the efficacy and safety of Small Bupleurum Decoction combined with repetitive transcranial magnetic stimulation and duloxetine hydrochloride in the treatment of female somatoform disorders.Meth⁃ods:A total of 90 female patients with somatoform disorders were randomly divided into three groups:control group No.1,control group No.2,observation group,with 30 cases in a group.The control group No.1 was treated with duloxetine hydrochloride capsules.The control group No.2 was treated with repetitive transcranial magnetic stimulation on the ba⁃sis of duloxetine hydrochloride capsules.The observation group was treated with Small Bupleurum Decoction on the ba⁃sis of the control group No.2.The three groups were treated continuously for 8 weeks.The changes of mental symptom self-rating scale(SCL-90)score,Hamilton depression scale(HAMD)score,Hamilton anxiety scale(HAMA)score,TCM syndrome score,serum 5-hydroxytryptamine(5-HT),norepinephrine(NE),estradiol(E_(2))and adverse events were observed in each group.Results:After 8 weeks of treatment,the scores of SCL-90,HAMD,HAMA and TCM syndromes in the observation group were lower than those in the control group No.1 and the control group No.2(P<0.05).After 8 weeks of treatment,the levels of serum 5-HT,NE and E_(2) in the three groups were higher than those before treat⁃ment and 4 weeks after treatment.The levels of 5-HT,NE and E_(2) in the control group 2 were higher than those in the control group No.1(P<0.05).The values of 5-HT,NE and E_(2) in the observation group were higher than those in the control group No.2(P<0.05).Conclusion:Small Bupleurum Decoction combined with repetitive transcranial magnetic stimulation and duloxetine hydrochloride can improve the somatic symptoms of female patients with somatoform disor⁃ders,and the curative effect is good.