中西医结合治疗围绝经期重度抑郁症的效果分析

目的:探讨中西医结合治疗方案对围绝经期重度抑郁症状的疗效及相关机制。方法:选取围绝经期抑郁症重度患者64例,随机分为观察组和对照组各32例。对照组给予常规治疗,观察组在对照组的基础上给予加味逍遥丸治疗(6g/次,2次/d,连用8周)。比较两组患者汉密尔顿抑郁表(HAMD)评分、临床疗效、血清中白细胞介素(IL)-6、IL-10和5-羟色胺(5-HT)水平变化及不良反应。结果:观察组在治疗第4w、8w时的HAMD评分均低于对照组,总有效率(90.6%)高于对照组(59.4%)(均P0.01)。与治疗前相比,观察组治疗后IL-6水平下降,IL-10和5-HT水平增加(均P0.01),且观察组IL-6降低水平和IL-10增高水平均优于对照组(P0.01),5-HT水平两组无差异(P0.05)。两组均无明显不良反应。结论:中西医结合治疗方案治疗围绝经期重度抑郁症患者疗效确切,安全性高,可通过降低患者IL-6水平、上调IL-10和5-HT的水平发挥治疗作用,值得临床应用。

Effect of traditional Chinese medicine combined with west medicine to treat patients with perimenopausal major depression

Objective:To discuss the effectiveness of traditional Chinese medicine combined with west medicine to treat patients with perimenopausal major depression,and to explore its related mechanism.Methods:64 patients with perimenopausal major depression were selected and divided into two groups randomly,which included observation group (n=32) and control group (n=32).The patients in control group were administrated with the routine treatment,and the patients in observation group were given Jiawei Xiaoyao pill (6 mg,Bid,lasting for 8 weeks) except routine treatment.The score of HAMD,clinical efficacy,and rate of adverse effect were compared between the two groups.Meanwhile,the levels of IL-6、IL-10 and 5-HT in serum of patients were detected and compared between the two groups.Results:At the end of the fourth and the eighth month after treatment,score of HAMD of patients in observation group was significant lower than that of patients in control group(P ＜0.01).The total efficacy rate of observation group was 90.6％,which was significant higher than that of control group(59.4％,P＜0.01).Compared with pretreatment,the IL-6 levels of patients in both groups were significant decreased,and level of IL-10 and 5-HT of patients in both groups were significant increased(P＜0.01).And after treatment,the degree of IL-6 level decreased or IL-10 level increased of patients in observation group were significant more than that of patients in the control group (P＜0.01),and there was no statistical significant difference in the degree of 5-HT level increased of patients between the two group(P＞0.05).There are no any side-effects in both groups.Conclusion:Traditional Chinese medicine combined with west medicine to treat patients with perimenopausal major depression has reliable effectiveness by decreasing the level of IL-6 and increasing the level of IL-10 and 5-HT in serum of patients,and also has good safety,so it is worth to clinical application.