解郁安神汤联合帕罗西汀治疗抑郁症的临床疗效 及对脑源性神经营养因子的影响

目的: 观察解郁安神汤联合帕罗西汀治疗抑郁症的临床疗效及对脑源性神经营养因子(BDNF)的影响。方法: 将85例抑郁症患者随机分为观察组43例和对照组42例。对照组口服帕罗西汀,20 mg,qd,并逐渐调整剂量;观察组在对照组基础上加用解郁安神汤,1剂/d,疗程均为6周。观察治疗前后汉密尔顿抑郁量表(HAMD)及中医症状评分,检测脑源性神经营养因子(BDNF)水平。结果: 观察组总有效率为95.34%优于对照组的80.95%(P<0.05);两组治疗后HAMD评分较治疗前下降(P<0.01),观察组HAMD评分低于对照组(P<0.01);两组治疗后血清BDNF水平较治疗前上升(P<0.01),观察组血清BDNF水平高于对照组(P<0.01);治疗后观察组中医证候总有效率为95.34%优于对照组的76.19%(P<0.05);治疗后观察组各主要症状评分及总有效率均明显低于对照组(P<0.01)。结论: 解郁安神汤联合帕罗西汀治疗抑郁症能降低HAMD评分,降低临床症状评分,提高疾病临床疗效及中医证候疗效,并且能升高血清BDNF水平,这可能是其重要作用机制。

Clinical Observation on the Treatment of Depression and the Influence to Brain-derived Neurotrophic Factor with Jieyu Anshen Decoction Paroxetine

Objective: To observe the clinical efficacy on the treatment of depression and the influence to brain-derived neurotrophic factor (BDNF) with Jieyu Anshen decoction plus Paroxetine. Method: Eighty-five patients were randomly divided into observation group (n=43) and control group (n=42). Patients in control group were treated with Paroxetine (20 mg, qd) and the dose was gradually adjusting. Jieyu Anshen decoction (one dose per day and six weeks as one cycle) was added to patients in observation group based on the treatment of the control group. HAMD, Chinese medical symptom rating, BDNF level were recorded. Result: The total efficacy of the observation group (95.34%) was significantly better than the control group (80.95%) (P<0.05). The HAMD score was decreased after treatment in two groups (P <0.01) and the score of observation group was lower than the control group (P<0.01). Serum BDNF levels in the two groups were higher after treatment in the two groups (P <0.01) and the observation group was significantly higher than the control group (P<0.01). The effective rate of Chinese medicine syndrome in the observation group (95.34%) was better than the control group (76.19%) (P<0.05). The main symptom score of the observation group were significantly lower than the control group after treatment (P<0.01). Conclusion: Treatment of Jieyu Anshen decoction combined with paroxetine in the treatment of depression could reduce the HAMD score and symptom scores, improve the clinical efficacy of disease and Chinese medical syndromes, it could also elevated serum BDNF levels, this may be an important mechanism of action.