柴胡加龙骨牡蛎汤联合艾司西酞普兰治疗肝气瘀滞型抑郁患者的疗效分析

Clinical ANALYSIs of Bupleurum plus Dragon Bone and Oyster Shell Decoction Combined with Escitalopram in the Treatment of Depression Patients with Liver Qi Stagnation

目的:分析肝气瘀滞型抑郁患者应用柴胡加龙骨牡蛎汤与艾司西酞普兰联合治疗的效果。方法:选取2022年1月—2023年6月罗源县精神病防治院和福州神经精神病防治院收治的114例肝气瘀滞型抑郁患者作为研究对象,根据治疗手段不同分为对照组和观察组,每组各57例。对照组给予艾司西酞普兰治疗,观察组应用艾司西酞普兰联合柴胡加龙骨牡蛎汤治疗。比较两组临床疗效、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分以及5-羟色胺(5-HT)、外周血中性粒细胞/淋巴细胞比值(NLR)、脑源性神经营养因子(BDNF)水平,同时比较不良反应情况。结果:观察组临床总有效率较对照组更高,差异有统计学意义(P<0.05)。治疗前,两组HAMA评分与HAMD评分比较,差异无统计学意义(P>0.05);治疗后,观察组各项目评分较对照组均更低,差异有统计学意义(P<0.05)。治疗前,两组5-HT、NLR及BDNF水平比较,差异无统计学意义(P>0.05);治疗后,观察组5-HT及BDNF水平较对照组更高,NLR水平较对照组更低,差异有统计学意义(P<0.05)。观察组不良反应总发生率较对照组低,差异有统计学意义(P<0.05)。结论:肝气瘀滞型抑郁患者应用柴胡加龙骨牡蛎汤联合艾司西酞普兰治疗有助于取得理想的抗抑郁效果,而且安全高效。

Objective:To analyze the effect of combined treatment of Bupleurum plus Dragon Bone and Oyster Shell Decoction,and escitalopram in patients with depression of Liver Qi Stagnation Type.Method:114 patients with depression of Liver Qi Stagnation Type who were treated in Luoyuan County Psychiatric Hospital and Fuzhou Neuropsychiatric Hospital from January 2022 to June 2023 were randomly selected and divided into the control group and the observation group according to the different treatment methods.The control group was treated with escitalopram,while the observation group was treated with escitalopram and Bupleurum plus Dragon Bone and Oyster Shell Decoction.The clinical efficacy,hamilton anxiety scale(HAMA)score,Hamilton depression scale(HAMD)score,5-hydroxytryptamine(5-HT),peripheral blood neutrophil/lymphocyte ratio(NLR).and brain derived neurotrophic factor(BDNF)levels of the two groups were compared,and adverse reactions were compared.Result:The clinical total effective rate of the observation group was higher than that of cpntrol groups,and the difference was statistically significant(P<0.05).There was no statistically significant difference in HAMA score and HAMD score between the two groups before treatment(P>0.05).After treatment,the scores of all items in observation group were lower than those in control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the levels of 5-HT,NLR,and BDNF between the groups before treatment(P>0.05).After treatment,the observation group had higher levels of 5-HT and BDNF,and lower levels of NLR,with statistical significance(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:The combined treatment of Bupleurum plus Dragon Bone and Oyster Shell Decoction in patients with depression of Liver Qi Stagnation Type is helpful to achieve ideal antidepressant effect,and is safe and effective.