调冲舒肝汤治疗肾虚肝郁型更年期抑郁症的临床分析

目的:观察调冲舒肝汤治疗更年期抑郁症(肾虚肝郁证)的疗效以及对血清5-羟色胺(5-HT)和色氨酸羟化酶2(TPH2)水平的影响。方法:选择更年期抑郁症女性患者共110例,参照数字表法随机分为治疗组和对照组各55例;对照组口服氟哌噻吨美利曲辛片,2片/d,早晨及中午各1片。治疗组在对照组治疗的基础上给予调冲舒肝汤治疗,1剂/d,早晚水煎煮内服。两组患者治疗均为8周。比较两组汉密尔顿抑郁(HAMD)量表因子和抑郁自评量表(SDS)评分;分析两组治疗后8周临床疗效;检测两组血清5-HT和TPH2水平。结果:治疗组患者的临床总有效率为96.36%,对照组为81.82%,治疗组明显高于对照组(P0.05);治疗组治疗后患者焦虑等HAMD量表各因子评分均明显低于对照组(P0.01);治疗后4周和8周评定,治疗组SDS评分均明显低于对照组同期时点,比较差异有统计学意义(P0.01);治疗组治疗后血清中5-HT和TPH2水平均明显高于对照组,比较差异有统计学意义(P0.01)。结论:在西医用药的基础上,调冲舒肝汤提高了治疗效果,能够降低更年期抑郁肾虚肝郁证HAMD和SDS的评分,其作用机制可能与下调血清5-HT和TPH2水平相关。

Clinical Analysis of Tiaochong Shugan Tang in Treating Menopausal Depression with Kidney Deficiency and Liver Qi Stagnation Syndrome

Objective: To observe the efficacy of Tiaochong Shugan Tang in treating menopausal depression with kidney deficiency and liver qi stagnation syndrome and investigate its effects on levels of 5-hydroxytryptamine (5-HT) and tryptophan hydroxylase-2 (TPH-2) in serum. Method: One hundred and ten menopausal depression patients were randomly divided into control group (55 cases) and treatment group (55 cases) by random number table. The patients in control group were treated with flupentixol and melitracen tablets by orally taking (2 tablets/day, 1 tablet in the morning and one at noon). Based on the treatment in control group, the patients in treatment group also received Tiaochong Shugan Tang, 1 dose/day and bid. The patients in both groups were treated for 8 weeks. Scores of Hamilton depression (HAMD) scale and scores of Self-Rating Depression Scale(SDS) were compared between 2 groups. Clinical efficacy was analyzed after treatment for 8 weeks in 2 groups. Levels of 5-HT and TPH2 in serum were detected in 2 groups. Result: The total clinical effective rate was 96.36% in treatment group, obviously higher than 81.82% in control group, with statistical difference (P<0.05). After treatment, scores in anxiety and other factors of HAMD scale in treatment group were significantly lower than those in control one (P<0.01). After 4 and 8 weeks'' treatment, scores of SDS in treatment group were significantly lower than those in control group at the same time, with statistical difference (P<0.01). After treatment, levels of 5-HT and TPH2 in serum of treatment group were significantly higher than those of control group, with statistical difference (P<0.01). Conclusion: Based on western medicine treatment, Tiaochong Shugan Tang could improve clinical symptoms, decrease scores of HAMD and SDS in treating menopausal depression with kidney Tang and liver qi stagnation syndrome, and the mechanism may be associated with down-regulating 5-HT and TPH2 levels in serum.