养阴清肝汤联合帕罗西汀治疗抑郁症躯体化症状研究

Title:

A comparative trial of a combined therapy (Yangyin-Qinggan decoction combined with paroxetine)versus mono-therapy on depressive patients with somatic symptoms

作者:

毛稚霞 杨媛 李根起 马静 王勇

300222 天津市安定医院中西医结合科

Author(s):

MAO Zhi-xia*;  YANG Yuan;  LI Gen-qi;  MA Jing;  WANG Yong

*Tianjin Anding hospital, Tianjin 300222, China

关键词:

抑郁症; 躯体化症状; 中医药; 对照研究

Keywords:

Depression; Somatic symptoms; Traditional Chinese medicine; Comparative trial

DOI:

10.3760/cma.j.issn.1673-4246.2013.01.016

摘要:

目的 探讨中西医结合治疗抑郁症患者躯体化症状的有效方法。方法 以简单随机法将入选患者分为两组，对照组35例、治疗组34组。治疗组给予中药养阴清肝汤联合盐酸帕罗西汀治疗，对照组单纯采用盐酸帕罗西汀治疗。比较两组患者治疗前后的抑郁症状及躯体化症状。结果 ①治疗组、对照组均可缓解抑郁症状：治疗组治疗前及治疗后2周、4周、8周的汉密尔顿抑郁量表(HAMD)评分分别为(19.29±2.38)分、(17.38±2.37)分、(15.27±2.15)分、(13.35±2.09)分；治疗后4周与治疗后2周比较、治疗后8周与治疗后4周比较，差异均有统计学意义(P均＜0.05)。对照组治疗前及治疗后2周、4周、8周的HAMD评分分别为(18.69±3.03)分、(16.63±3.09)分、(15.20±2.95)分、(14.60±2.72)分，治疗后4周与治疗后2周比较、治疗后8周与治疗后4周比较，差异均有统计学意义(P均＜0.05)。治疗结束时，两组HAMD比较治疗组优于对照组(P＜0.05)。②在改善躯体化症状方面，治疗组治疗前及治疗后2周、4周、8周的躯体化症状自评量表(SSS)评分分别为(48.74±4.07)分、(46.74±4.16)分、(43.74±3.77)分、(41.18±3.50)分；治疗后4周与治疗后2周比较、治疗后8周与治疗后4周比较，差异均有统计学意义(P均＜0.05)。对照组治疗前及治疗后2周、4周、8周的躯体化症状自评量表(SSS)评分分别为(47.71±4.72)分、(46.20±4.64)分、(44.80±4.52)分、(43.91±4.31)分，治疗后4周与治疗后2周比较、治疗后8周与治疗后4周比较，差异无统计学意义(P均＞0.05)。结论 养阴清肝汤联合盐酸帕罗西汀可有效缓解抑郁症状，改善躯体化症状。

Abstract:

Objective To evaluate the effectiveness of treating depressive patients with somatic symptoms with combined TCM and western medicine. Methods 69 patients were randomly divided into 2 groups: a combined therapy group (treated with Yangyin-Qinggan decoction and paroxetine) and mono-therapy (treated with paroxetine alone as an active control), The depressive and somatic symptoms were assessed before (0 week), during (2 weeks and 4 weeks) and at the end point (8 weeks) of the treatment. Results ①Both therapies alleviated the depressive symptoms: HAMD assessed among patients receiving combined therapy are listed as: (0 week: 19.29±2.38),(2 weeks:17.38±2.37),(4 weeks:15.27±2.15),(8 weeks:13.35±2.09); combined therapy started to ease the depressive symptoms after 2 weeks of treatment (2 week compared with 0 weeks), similar improvements could also be noticed after 4 weeks of treatment 4 weeks with 2 weeks: P＜0.05) and at the end of this research (after 8 weeks of treatment: 8 weeks with 4 weeks: P＜0.05). HAMD for mono-therapy are as: (0 week: 18.69±3.03),(2 weeks: 16.63±3.09),(4 weeks: 15.20±2.95),(8 weeks: 14.60±2.72); mono-therapy started to alleviate the depressive symptoms also, after 2 weeks of treatment (2 weeks compared with 0 week: P＜0.05), yet only slight improvements could be seen after 4 weeks (4 weeks with 2 weeks: P＞0.05) and 8 weeks of the treatment (8 weeks with 4 weeks: P＞0.05). The combined therapy turned to be more effective in alleviating depressive symptoms at the end point of the treatment (P＜0.05). ②In terms of improving the somatic symptoms, the Somatization Symptom Scale (SSS) among patients with combined therapy were as follows: (0 week: 48.74±4.07),(2 weeks: 46.74±4.16),(4 weeks: 43.74±3.77),(8 weeks: 41.18±3.50)；Combined therapy was witnessed to start to ease those symptoms after 2 weeks of treatment(2 week compared with 0 weeks, P＜0.05), similar patterns were found again, after 4 weeks(4 weeks with 2 weeks: P＜0.05) and 8 weeks of the treatment (8 weeks with 4 weeks: P＜0.05). Mono-therapy was found to ease the somatic symptoms in a less-effective way，yet no difference was found between any two SSS after 2 weeks, 4 weeks or 8 weeks of treatment (P＞0.05, respectively). Combined therapy was better at improving the somatic symptoms (P＜0.01). Conclusion Combined therapy proved to be more effective in both relieving depression and somatic symptoms.