归脾汤治疗心脾两虚型老年抑郁症患者的 疗效及对睡眠质量的影响

目的 探讨归脾汤治疗心脾两虚型老年抑郁症的临床疗效及对患者睡眠质量的影响。方法 选择金华市第二医院2019年1月至2021年11月收治的120例心脾两虚型老年抑郁症患者作为研究对象，随机分为观察组和对照组，每组60例，对照组服用草酸艾司西酞普兰片，观察组服用归脾汤，疗程均为4周。比较两组患者治疗前后汉密尔顿抑郁量表（Hamilton depression scale，HAMD）评分中医证候评分、匹兹堡睡眠质量指数（Pittsburgh sleep quality index，PSQI）评分及服药安全性。结果 服药前两组的HAMD评分、中医证候评分比较，差异无统计学意义（P>0.05），服药后观察组HAMD评分、中医证候评分低于对照组，观察组HAMD评分和中医症候评分评估的总有效率高于对照组（P<0.05）。服药前两组PSQI评分比较，差异无统计学意义（P>0.05），服药后观察组PSQI评分低于对照组（P<0.05）。两组服药过程中均未发生严重不良事件。结论 归脾汤治疗心脾两虚型老年抑郁症效果优于草酸艾司西酞普兰片，可显著改善患者的抑郁状态，减少中医证候评分，提升睡眠质量，安全性高。

Guipi decoction in the treatment of elderly depression with deficiency of both heart and spleen and its effect on sleep quality

Objective To explore the clinical effect of Guipi decoction in treated senile depression with deficiency of both heart and spleen and its influence on patients'' sleep quality. Methods A total of 120 cases of elderly depression with heart and spleen deficiency were admitted to Jinhua Second Hospital from January 2019 to November 2021 were selected as the research subjects and retrospectively analyzed. Accorded to different treatment methods, they were divided into two groups, each group 60 cases. The control group took escitalopram oxalate tablets, and the observation group took Guipi decoction. The course of treatment was 4 weeks. The efficacy of Hamilton depression scale (HAMD), the efficacy of syndromes, the score of Pittsburgh sleep quality index (PSQI) and the safety of medication were compared between the two groups before and after treated. Results There was no significant difference in HAMD score and syndrome score between the two groups before taked the medicine (P>0.05). After taking the medicine, the HAMD score and the syndrome score in the observation group were lower than control group, the total effective rate of HAMD efficacy and the total effective rate of syndrome efficacy were higher than control group, the difference was significant (P<0.05). There was no significant difference in PSQI scores between the two groups before taked the medicine (P>0.05). After taked the medicine, the PSQI score of the observation group was lower than control group (P<0.05). No serious adverse events occurred in the two groups during the medication. Conclusion Guipi decoction is better than escitalopram oxalate in treating elderly depression with heart and spleen deficiency. It can significantly improving the patient''s depression, reducing the scores of TCM syndromes, improving sleep quality, and have high safety.