摘要
目的 观察九味镇心颗粒结合舍曲林对伴非自杀性自伤青少年抑郁症患者抑郁情绪、自伤水平及冲动行为的影响.方法 前瞻性选取2022年1月至2023年2月潍坊市精神卫生中心收治的65例伴非自杀性自伤青少年抑郁症患者,按照奇偶数分组法分为舍曲林组(n=32)和联合组(n=33).舍曲林组给予舍曲林治疗,联合组给予九味镇心颗粒结合舍曲林治疗.两组疗程均为8周.评估并比较两组治疗前和治疗8周后的自我伤害行为筛选量表评分、情绪调节困难量表(DERS)评分、汉密尔顿抑郁量表(HAMD)评分、抑郁自评量表(SDS)评分、Barratt冲动量表(BIS-Ⅱ)评分差异,检测两组治疗前和治疗8周后的神经递质(5-羟色胺、P物质、皮质醇)水平,记录并比较两组不良反应.结果 治疗8周后,联合组的忧郁孤独、自残自杀、退缩与自我批评及总分分别为(5.82±1.47)、(2.56±0.78)、(2.95±0.95)、(15.57±3.11)分,均低于舍曲林组[(7.95±1.89)、(4.25±1.06)、(3.57±1.24)、(20.03±3.56)分],差异均有统计学意义(P＜0.05),而攻击违纪、行为改变评分与舍曲林组比较,差异均无统计学意义(P＞0.05).治疗8周后,联合组的 HAMD 评分、SDS 评分、DERS 评分、BIS-Ⅱ 评分分别为(11.74±3.04)、(28.78±4.12)、(105.85±15.43)、(24.17±3.86)分,均低于舍曲林组[(15.45±3.56)、(39.45±4.56)、(114.56±14.62)、(27.23±4.11)分],差异均有统计学意义(P＜0.05).治疗8周后,联合组5-羟色胺水平为(89.52±5.04)ng/mL,高于舍曲林组[(43.69±4.75)ng/mL],P 物质、皮质醇水平分别为(37.95±7.44)ng/L、(72.25±18.89)μg/L,均低于舍曲林组[(46.54±8.12)ng/L、(95.85±21.04)μg/L],差异均有统计学意义(P＜0.05).两组不良反应发生率比较,差异无统计学意义(P＞0.05).结论 九味镇心颗粒结合舍曲林可减轻伴非自杀性自伤青少年抑郁症患者抑郁情绪,减轻自伤和冲动行为,可能与调节神经递质有关.
Abstract
Objective To observe the effects of Jiuwei Zhenxin Granules combined with sertraline on depressive mood,level of self-inju-ry and impulsive behavior in adolescent depression with non-suicidal self-injury.Methods A total of 65 adolescent depression patients with non-suicidal self-injury admitted to Weifang Mental Health Center from January 2022 to February 2023 were prospectively selected,and divided into the sertraline group(n=32)and the combined group(n=33)by odd-even grouping method.The sertraline group was given sertraline treatment,and the combined group was given Jiuwei Zhenxin Granules combined with sertraline treatment.The course of treatment in both groups was 8 weeks.The differences in scores of the self-harming Behavior Screening Scale,difficulties in emotion regulation scale(DERS),depressive mood Scale and Barratt Impulsiveness Scale(BIS-Ⅱ)before treatment and 8 weeks after treatment were evaluated and compared between the two groups.The levels of neurotransmitter(5-hydroxytryptamine,substance P,cortisol)before treatment and 8 weeks after treatment were detected between the two groups,and adverse reactions were recorded and compared.Results After 8 weeks of treatment,the scores of depression and loneliness,self-mutilation and suicide,withdrawal and self-criticism and total score in the combined group were(5.82±1.47),(2.56±0.78),(2.95±0.95),(15.57±3.11)points,which were lower than those in the sertraline group[(7.95±1.89),(4.25±1.06),(3.57±1.24),(20.03±3.56)points],and the differences were statistically significant(P＜0.05);there were no significant differences in the scores of ag-gression and behavior change between the two groups(P＞0.05).After 8 weeks of treatment,the HAMD score,SDS score,DERS score and BIS-Ⅱ score of the combined group were(11.74±3.04),(28.78±4.12),(105.85±15.43)and(24.17±3.86)points,respectively,which were lower than those of the sertraline group[(15.45±3.56),(39.45±4.56),(114.56±14.62)and(27.23±4.11)points],and the differences were statistically significant(P＜0.05).After 8 weeks of treatment,the level of 5-hydroxytryptamine in the combined group was(89.52±5.04)ng/mL,which was higher than that in the sertraline group[(43.69±4.75)ng/mL],and the levels of substance P and cortisol were(37.95±7.44)ng/L,(72.25±18.89)μg/L,respectively,which were lower than those in the sertraline group[(46.54±8.12)ng/L,(95.85±21.04)μg/L],and the differences were statistically significant(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Jiuwei Zhenxin Granules combined with sertraline can reduce depressive mood,self-injury and impulsive behavior in adolescents with non-suicidal self-injury,which may be related to the regulation of neurotransmitters.
基金项目
山东省医药卫生科技发展计划项目(202014011077)
NETL
NSTL
万方数据