清心解郁方对肝郁脾虚型抑郁症患者的疗效分析

Effect of Qingxin Jieyu Decoction(清心解郁方)on Depression Patients with Liver Depression and Spleen Deficiency Type

目的探讨清心解郁方辅助治疗对肝郁脾虚型抑郁症患者疗效、睡眠质量及甲状腺功能的影响。方法选取2020年3月—2022年3月于该院就诊并接受治疗的76例肝郁脾虚型抑郁症患者,按随机数字表法分为研究组和对照组,每组38例,对照组单独采用西药治疗,研究组在对照组的基础上联合清心解郁方辅助治疗,评估两组患者的临床疗效,观察两组患者治疗前后的睡眠质量、中医证候积分、血游离三碘甲状腺原氨酸(blood free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)、三碘甲状腺原氨酸(triiodothyronine,T3)、甲状腺素(thyroxine,T4)、促甲状腺激素(thyroid stimulating hormone,TSH)甲状腺功能指标水平以及治疗期间不良事件发生情况。结果研究组临床总有效率[92.11%(35/38)]高于对照组[73.68%(28/38)](P<0.05);两组治疗后睡眠时间、入眠时间、日间功能、睡眠质量、睡眠效率、睡眠障碍评分均低于治疗前(P<0.05),且治疗后研究组上述评分均低于对照组(P<0.05);两组治疗后急躁易怒、胸肋胀满、情志抑郁、悲观厌世、神思不聚评分均低于治疗前(P<0.05),且治疗后研究组上述评分均低于对照组(P<0.05);两组治疗后FT3、FT4、TSH、T3、T4水平均高于治疗前(P<0.05),且治疗后研究组上述指标水平均高于对照组(P<0.05);研究组不良事件发生率(5.26%,2/38)低于对照组(26.32%,10/38)(P<0.05)。结论清心解郁方辅助治疗可以提升肝郁脾虚型抑郁症患者的临床疗效,改善患者的睡眠质量和中医证候积分,提高甲状腺素水平,改善甲状腺功能,且不良事件发生率低。

Objective To explore the effect of Qingxin Jieyu Decoction(清心解郁方)on the efficacy,sleep quality and thyroid function of patients with liver depression and spleen deficiency depression.Methods Seventy-six patients with liver depression and spleen deficiency depression who were treated in the hospital from March 2020 to March 2022 were randomly divided into the study group and the control group,with 38 cases in each group.The control group was treated with western medicine alone,and the study group was treated with Qingxin Jieyu Decoction on the basis of the control group.The clinical efficacy of the two groups was evaluated,and the sleep quality,TCM syndrome scores and thyroid function index levels[blood free triiodothyronine(FT3),free thyroxine(FT4),triiodothyronine(T3),thyroxine(T4),thyroid stimulating hormone(TSH)]and adverse events during treatment were observed.Results The total clinical effective rate in the study group was 92.11%(35/38),higher than 73.68%(28/38)in the control group(P<0.05).The sleep time,sleep time,daytime function,sleep quality,sleep efficiency and sleep disorder scores of the two groups after treatment were lower than those before treatment(P<0.05),and the above scores of the study group after treatment were lower than those of the control group(P<0.05).After treatment,the scores of irritability,chest and rib fullness,emotional depression,pessimism and lack of concentration in the two groups were lower than those before treatment(P<0.05),and the above scores in the study group were lower than those in the control group after treatment(P<0.05).The levels of FT3,FT4,TSH,T3 and T4 in the two groups after treatment were higher than those before treatment(P<0.05),and the levels of the above indicators in the study group were higher than those in the control group after treatment(P<0.05).The incidence of adverse events in the study group was 5.26%(2/38),lower than 26.32%(10/38)in the control group(P<0.05).Conclusion The auxiliary treatment of Qingxin Jieyu Decoction can improve the clinical efficacy improve sleep quality,TCM syndrome scores,the level of thyroxine and thyroid function of depression patients with liver depression and spleen deficiency type and has a low incidence of adverse events.