解郁安神汤联合盐酸氟西汀治疗青少年轻中度抑郁症临床研究

Clinical Study on Jieyu Anshen Decoction Combined with Fluoxetine Hydrochloride for Adolescents with Mild to Moderate Depression

目的:观察解郁安神汤联合盐酸氟西汀治疗青少年轻中度抑郁症肝郁脾虚证的临床疗效。方法:选取90例青少年轻中度抑郁症肝郁脾虚证患者,以随机数字表法分为对照组和治疗组各45例。对照组给予盐酸氟西汀胶囊治疗,治疗组在对照组基础上给予解郁安神汤治疗,2组均治疗4周。比较2组临床疗效、中医证候积分、汉密尔顿抑郁量表(HAMD)评分、血清单胺类神经递质水平及炎症因子水平。结果:治疗4周,治疗组总有效率91.11%,高于对照组73.33%(P<0.05)。2组中医证候积分均较治疗前降低(P<0.05),治疗组中医证候积分低于对照组(P<0.05)。治疗2周、4周,2组HAMD评分均较治疗前降低(P<0.05)。治疗2周,2组HAMD评分比较,差异无统计学意义(P>0.05)。治疗4周,治疗组HAMD评分低于对照组(P<0.05)。治疗4周,2组血清5-羟色胺(5-HT)水平均较治疗前升高(P<0.05),血清去甲肾上腺素(NE)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平均较治疗前降低(P<0.05);治疗组血清5-HT水平高于对照组(P<0.05),血清NE、IL-2、IL-6、TNF-α水平均低于对照组(P<0.05)。结论:解郁安神汤联合盐酸氟西汀治疗青少年轻中度抑郁症肝郁脾虚证疗效显著,有利于减轻患者的临床症状,改善抑郁状态,其作用机制可能与调节血清单胺类神经递质及炎症因子水平有关。

Objective:To observe the clinical effect of Jieyu Anshen Decoction combined with Fluoxetine Hydrochloride on adolescents with mild to moderate depression with liver depression and spleen deficiency syndrome.Methods:A total of 90 cases of adolescents with mild to moderate depression with liver depression and spleen deficiency syndrome were selected and divided into the control group and the treatment group according to the random number table method,with 45 cases in each group.The control group was treated with Fluoxetine Hydrochloride Capsules,and the treatment group was additionally treated with Jieyu Anshen Decoction based on the treatment of the control group.Both groups were treated for 4 weeks.The clinical effects,traditional Chinese medicine(TCM)syndrome scores,Hamilton Depression Scale(HAMD)scores,and the levels of serum monoamine neurotransmitters and inflammatory factors were compared between the two groups.Results:After 4 weeks of treatment,the total effective rate was 91.11%in the treatment group,higher than that of 73.33%in the control group(P<0.05).The TCM syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and which was lower in the treatment group than that in the control group(P<0.05).After 2 and 4 weeks of treatment,HAMD scores in the two groups were decreased when compared with those before treatment(P<0.05).After 2 weeks of treatment,there was no significant difference being found in the comparison of HAMD scores between the two groups(P>0.05).After 4 weeks of treatment,HAMD score in the treatment group was lower than that in the control group(P<0.05).After 4 weeks of treatment,the levels of 5-hydroxytryptamine(5-HT)in serum in the two groups were increased when compared with those before treatment(P<0.05),and the levels of norepinephrine(NE),interleukin-2(IL-2),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)in serum were decreased when compared with those before treatment(P<0.05).The level of serum 5-HT in the treatment group was higher than that in the control group(P<0.05),and the levels of NE,IL-2,IL-6,and TNF-αin serum were lower than those in the control group(P<0.05).Conclusion:Jieyu Anshen Decoction combined with Fluoxetine Hydrochloride for adolescents with mild to moderate depression with liver depression and spleen deficiency syndrome has a significant curative effect,which can reduce clinical symptoms and improve depressive state.Its action mechanism can be related to regulating the levels of monoamine neurotransmitters and inflammatory factors.