文章摘要
柴胡疏肝散加减对老年抑郁患者临床疗效及生活质量分析
Analysis of clinical efficacy of the modified chaihu shugan san and the influence on the quality of life in senile depression
投稿时间:2021-02-07  修订日期:2021-02-07
DOI:
中文关键词: 柴胡疏肝散  老年抑郁  躯体症状  生活质量
英文关键词: Chaihu Shugan San  senile depression  physical symptoms  quality of life
基金项目:
作者单位邮编
熊盈 熊盈 100010
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中文摘要:
      目的 观察柴胡疏肝散加减联合草酸艾司西酞普兰对肝郁气滞型老年抑郁患者症状及生活质量的影响,进一步探讨了柴胡疏肝散加减治疗老年抑郁症的临床疗效及相关作用机制。方法 选取 2016年 6 月 至 2020年1月期间收治的肝郁气滞型老年抑郁患者 60例,按不平衡指数最小分配原则随机分为对照组和治疗组,每组各 30 例。对照组给予艾司西酞普兰治疗,治疗组在对照组的治疗基础上给予柴胡疏肝散加减治疗。观察两组患者治疗前后汉密顿抑郁量表(HAMD-24)、生活质量评价量表评分(SF-36)、躯体症状评分(SCL-90),血清神经营养因子(BNDF)、神经生长因子(NGF)、肿瘤坏死因子(TNF-α)的变化及不良反应发生率,并比较两组患者治疗后中医证候评分及临床疗效。结果 治疗组临床显效治愈率(93.3%)明显高于对照组(66.7%),具有明显的显效、治愈效果(P<0.05)。两组治疗后,与对照组比较,观察组患者 HAMD-24评分、中医证候评分、躯体症状因子SCL-90评分明显降低,SF-36中情感职能、精神健康2项评分均高于对照组,血清中 BDNF 水平明显升高,TNF-α水平明显降低,差异有统计学意义(P<0.05);NGF水平虽有降低,但差异无统计学意义(P>0.05)。治疗组不良反应发生率(6.7%)明显低于对照组(36.7%),两组比较差异有统计学意义(P<0.05)。结论 柴胡疏肝散联合草酸艾司西酞普兰治疗能改善肝郁气滞型老年抑郁症患者的抑郁躯体症状,提高了生活质量水平,有效的降低患者不良反应,具有较高的治疗价值。
英文摘要:
      Objective The study aimed to explore the treatment effect and role of the modified Chaihu Shugan San on senile depression patients of the Stagnation of Qi due to depression of the liver,discussed the related mechanism of Chaihu Shugan San, and lays the foundation for clinical application of Chaihu Shugan San. Methods Clinical 60 senile depression patients with Stagnation of Liver-qi type were selected, each group studied 30 patients including a control group with drug treatment of escitalopram oxalate tablets and an observation group added with Chaihu Shugan San, a traditional Chinese medicine(TCM). After taking the medicine for 6 weeks,some indexes were analysis including HAMD-24,TCM score,SF-36,SCL-90,BDNF,NGF, TNF-α and the evaluation and analysis were summarized and compared with those before treatment to explore the therapeutic effect and mechanism of Chaihu Shugan San. Result After treatment,compared with the control group,HAMD-24 score、TCM score and SCL-90 score were reduced obviously, SF-36 scores of the affective function and mental health were significantly better than the control group (P< 0.05), the level of serum BDNF was increased and TNF-αreduced in the observation group,indicating the statistical significance (P<0.05). NGF was reduced but without statistical significance (P>0.05). The incidence of adverse reaction was 6.7% in the observation group and was lower obviously than the control group(36.7% ), indicating the statistical significance (P< 0.05).Conclusion Chaihu Shugan Powder combined with escitalopram can improve physical symptoms and the quality of life and reduce the incidence of adverse reactions in the senile depression patients of the Stagnation of Qi due to depression of the liver. Hence,this therapy deserves to be promoted in clinical practice.
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