草酸艾司西酞普兰联合复方解郁汤治疗青少年抑郁症的临床疗效分析

Clinical Analysis of Escitalopram Oxalate Combined with Compound Jieyu Decoction(复方解郁汤)in Treatment of Adolescent Depression

目的 探讨草酸艾司西酞普兰联合复方解郁汤治疗青少年抑郁症的临床疗效。方法 选择该院2021年12月—2022年12月期间精神科收治青少年抑郁症患者86例,按照随机数字表法分试验组(43例)和对照组(43例)。所有患者均予以认知行为疗法治疗,对照组予以草酸艾司西酞普兰片,试验组在对照组的基础上联用复方解郁汤治疗。两组均以4周为1个疗程,共治疗2个疗程。对比两组治疗前后脑源性神经营养因子水平、血清炎症因子水平、单胺类神经递质水平、抑郁情况评分、睡眠质量评分、自杀态度评分,观察并评估两组治疗效果及治疗期间不良反应。结果 与治疗前比,治疗后两组BDNF水平较高,IL-1β、IL-6、TNF-α水平降低;与对照组比,治疗后试验组BDNF水平较高,IL-1β、IL-6、TNF-α水平较低(P<0.05)。与治疗前比,治疗后两组NE、5-HT、DA水平升高;与对照组比,治疗后试验组NE、5-HT、DA水平较高(P<0.05)。与治疗前比,治疗后两组HAMA及PSQI评分降低;与对照组比,治疗后试验组HAMA及PSQI评分较低(P<0.05)。试验组临床总有效率较对照组高,差异有统计学意义(P<0.05)。与治疗前比,治疗后两组自杀意念QSA评分较高;与对照组比,治疗后试验组自杀意念QSA评分较高(P<0.05)。两组均未出现严重不良反应,比较差异无统计学意义(P>0.05)。结论 草酸艾司西酞普兰联合复方解郁汤对青少年抑郁症患者的治疗效果显著,能上调脑源性神经营养因子及单胺类神经递质水平,降低血清炎症因子水平,改善睡眠质量及自杀意念,不良反应较少,是一种安全有效的治疗方案。

Objective To explore the clinical effect of escitalopram oxalate combined with Compound Jieyu Decoction(复方解郁汤)in the treatment of adolescent depression.Methods A total of 86 adolescent patients with depression admitted to the psychiatric department of the hospital from June 2020 to June 2022 were selected as research objects,and were divided into experimental group and control group according to random number table method,with 43 cases in each group.All patients were treated with cognitive behavioral therapy.The control group was treated with Escitalopram Oxalate Tablets,and the experimental group was treated with Compound Jieyu Decoction on the basis of the control group.Two groups were treated with a 4-week treatment course,a total of 2 courses.The levels of brain-derived neurotrophic factor,serum inflammatory factor,monoamine neurotransmitter,depression score,sleep quality score and suicidal attitude score before and after treatment were compared between the two groups.The therapeutic effect and adverse reactions during treatment were observed and evaluated.Results Compared with those before treatment,the levels of brain-derived neurotrophic factor(BDNF)in two groups after treatment were higher,and the levels of interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis-α(TNF-α)were lower.Compared with those of the control group,the levels of BDNF and IL-1β,IL-6 and TNF-αwere higher in experimental group after treatment,and the difference was statistically significant(P<0.05).Compared with the control group,the levels of BDNF,IL-1β,IL-6 and TNF-αwere higher in the experimental groups after treatment(P<0.05).Compared with those before treatment,the levels of norepinephrine(NE),5-hydroxytryptamine(5-HT)and dopamine(DA)were increased in the two groups after treatment.Compared with those in the control group,the levels of NE,5-HT and DA in the experimental group were higher after treatment(P<0.05).Compared with those before treatment,Hamilton depression scale(HAMA)and Pittsburgh sleep quality index(PSQI)scores of the two groups decreased after treatment.Compared with those of the control group,HAMA and PSQI scores of the experimental group were lower after treatment(P<0.05).The total clinical effective rate of the experimental group was higher than that of the control group,and the difference was statistically significant(P<0.05).Compared with those before treatment,the suicide attitude questionnaire(QSA)score of suicidal ideation was higher in the two groups after treatment.Compared with that in the the control group,the QSA score of suicidal ideation in the experimental group was higher after treatment(P<0.05).There was no significant adverse reaction between the two groups(P>0.05).Conclusion Escitalopram oxalate combined with Compound Jieyu Decoction has a significant therapeutic effect on adolescent patients with depression,which can increase the levels of BDNF and monoamine neurotransmitters,reduce the levels of serum inflammatory factors and improve sleep quality and suicidal ideation,with fewer adverse reactions.It is a safe and effective treatment program.