| 林晨,王冠军,戴霓,张庆玉,胡昕昕,季蕴辛.归脾汤辅助治疗心脾两虚型抑郁症的临床疗效及对认知功能的影响研究[J].浙江中西医结合杂志,2023,33(7): |
| 归脾汤辅助治疗心脾两虚型抑郁症的临床疗效及对认知功能的影响研究 |
| Effects of Guipi Decoction on Clinical Efficacy and Cognitive Function in Patients with Major Depressive Disorder of Heart and Spleen Deficiency |
| 投稿时间：2022-08-04 修订日期：2022-11-06 |
| DOI： |
| 中文关键词: 抑郁症 心脾两虚 归脾汤 认知功能 |
| 英文关键词:Depressive disorder Deficiency of heart and spleen Guipi Decoction Cognitive function |
| 基金项目:浙江省中医药科技计划:基于脑-肠轴理论探讨归脾汤在加速抗抑郁及改善认知功能中的作用(2021ZB260)；郁证患者的中医证型与肠道菌群结构的相关性研究(2020ZB219) |
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| 中文摘要: |
| 目的：探讨归脾汤联合艾司西酞普兰治疗心脾两虚型抑郁症的临床疗效、起效时间、不良反应以及对认知功能的影响。方法：120例心脾两虚型抑郁症患者随机分为研究组60例，对照组60例，研究组给予归脾汤加艾司西酞普兰治疗，对照组仅给予艾司西酞普兰治疗，疗程4周。评估两组治疗前及治疗第1、2、3、4周汉密尔顿抑郁量表（Hamilton Depression Scale,HAMD-17）、汉密尔顿焦虑量表（Hamilton Anxiety Scale, HAMA）、抗抑郁药副反应量表（Rating Scale for Side Effects,SERS）评分，并运用Thinc-it工具评估治疗前后认知功能水平。结果：（1）研究组1周有效率23.3%，4周有效率75%，对照组分别为8.3%和53.3%，两组差异有统计学意义（P＜0.05）。（2）治疗4周后研究组HAMD-17、HAMA、SERS评分均低于对照组（P＜0.05）。其中，与对照组相比，研究组焦虑/躯体化因子、认知障碍及迟滞因子分下降更明显（P＜0.05），疲劳、心悸、出汗、口干、便秘及胃肠道反应的发生率更低（P＜0.05）。（3）治疗4周后研究组PDQ-5-D评分下降、CRT及1-back计数升高均较对照组明显(P＜0.05)。结论：联合归脾汤治疗心脾两虚型抑郁症能提高临床疗效，加快起效时间，减少不良反应，特别对减轻焦虑、躯体化、迟滞症状及疲劳、心悸、出汗、口干、便秘和胃肠道反应更优，而且能改善认知功能，尤其在是主观认知功能和记忆力、信息加工速度及注意力方面，优于单用西药治疗。 |
| 英文摘要: |
| Objective：To investigate the clinical efficacy, onset time, adverse reactions and cognitive function of Guipi Decoction combined with escitalopram in the treatment of depression with deficiency of heart and spleen.? Method：120 patients with depressive disorder of heart and spleen deficiencyd were randomly divided into a research group (60 cases, treated with Guipi Decoction combined with escitalopram) and a control group (60 cases, treated with escitalopram alone). The therapeutic course for all was 4 weeks. Hamilton Depression Scale（HAMD-17）, Hamilton Anxiety Scale（HAMA）and Rating Scale for Side Effects（SERS）were assessed before and after the treatment of 1, 2, 3,4 weeks. The cognitive function was assessed by Thinc-it tool before and after treatment.?Results: (1) The effective rate was 23.3% in the research group at 1 week and 75% at 4 weeks,compared with 8.3% and 53.3% in controls, with statistically significant differences (P<0.05). (2) After 4 weeks of treatment, the HAMD-17, HAMA and SERS scores in the research group were lower than those in controls (P<0.05). Among them, compared with the control group, the anxiety/somatization factor, cognitive impairment and hysteresis factor scores in the research group decreased more significantly (P< 0.05), and the incidence of fatigue, palpitations, sweating, dry mouth, constipation and gastrointestinal reactions was lower (P < 0.05).?(3) After 4 weeks of treatment, the PDQ-5-D scores decreased and the CRT and 1-BACK count increased significantly in the research group compared with the controls (P < 0.05).? Conclusion: (1) Combined with Guipi decoction in the treatment of MDD can not only improve the clinical efficacy, accelerate the onset time, reduce adverse reactions, especially to reduce symptoms of anxiety, somatization, retardation and fatigue, palpitation, sweating, dry mouth, constipation, and gastrointestinal reaction of better, and can improve cognitive function, especially subjective cognitive function, memory, information processing speed and attention, superior to antidepressant alone. |
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