中药联合心理疏导治疗围绝经期抑郁症临床研究

目的：观察中药联合心理疏导治疗围绝经期抑郁症的疗效。方法：将90例患者随机分为3组,治疗组口服滋水清肝饮联合心理疏导治疗;中药对照组予滋水清肝饮口服;西药对照组予激素替代治疗。观察治疗前后血清内分泌激素雌二醇（E2）、卵泡刺激素（FSH）、黄体生成素（LH）和血浆单胺类神经递质去甲肾上腺素（NE）、多巴胺（DA）、五羟色胺（5-HT）的变化。结果：总有效率治疗组为80.0%,中药对照组为53.3%,西药对照组为56.7%,治疗组分别与中药、西药对照组比较,差异均有显著性意义（P〈0.05）。治疗后3组患者血清E2水平均较治疗前升高,FSH、LH水平均下降,与治疗前比较,差异均有非常显著性意义（P〈0.01）。3组间治疗后E2、FSH、LH水平分别比较,差异均无显著性意义（P〉0.05）。治疗组治疗后血浆NE、DA、5-HT含量均较治疗前升高,差异均有非常显著性意义（P〈0.01）。中药、西药对照组部分指标较治疗前有升高,差异有显著性意义（P〈0.05）。治疗组分别与中药、西药对照组比较,差异均有显著性或非常显著性意义（P〈0.05,P〈0.01）。结论：滋水清肝饮联合心理疏导治疗围绝经期抑郁症疗效满意。

Clinical Study of Traditional Chinese Medicine Combined with Psychotherapy in Treatment of Perimenopausal Depression

Objective：To observe the therapeutic effect of traditional Chinese medicine combined with psychotherapy in treatment of perimenopausal depression.Methods：Ninety patients were randomly divided into 3 groups：the treatment group received Zishui Qinggan Decoction combined with psychotherapy,the Chinese medicine（CM） control group was treated with Zishui Qinggan Decoction,and the western medicine（WM） control group was given hormone replacement therapy.Serum levels of hormones such as estradiol（E2）,luteinizing hormone（LH）,and follicle-stimulating hormone（FSH）,and plasma monoamine neurotransmitters such as norepinephrine（NE）,dopamine（DA）,and 5-hydroxy tryptamine（5-HT） were detected before and after treatment.Results：The total effective rate was 80.0% in the treatment group,53.3% in the CM control group,and 56.7% in the CM control group,the difference being significant between the treatment group and the other two groups（P 0.05）.In three groups,post-treatment serum E2 level was significantly higher,and the levels of FSH and LH were significantly lower than those before treatment（P 0.01）.After treatment,no statistical significant difference was found among three groups（P 0.05）.Post-treatment plasma NE,DA and 5-HT levels in the treatment group were significantly increased（P 0.01 compared with those before treatment）,while in the CM control group and the WM control group,only some of the indexes were significantly increased（P 0.05 compared with those before treatment）.There were significant or very significant differences among the treatment group and the other two groups（P 0.05 or P 0.01）.Conclusion：Zishui Qinggan Decoction combined with psychotherapy shows satisfactory therapeutic effect on perimenopausal depression.