摘要
目的 观察升阳益胃汤联合5-羟色胺再摄取抑制剂(SSRI)类药物治疗抑郁障碍的疗效.方法 采用随机数字表法,将2020 年12 月—2022 年5 月在河北省精神卫生中心门诊或住院治疗的120 例抑郁障碍患者分为对照组和观察组,每组 60 例.对照组给予SSRI类药物治疗,观察组给予SSRI类药物联合升阳益胃汤治疗,2 组均连续治疗8 周.比较2 组治疗2 周、4 周、8 周后汉密尔顿抑郁量表17(HAMD17)评分、汉密尔顿焦虑量表(HAMA)评分、躯体化症状问卷(SSI)评分、匹兹堡睡眠质量指数量表(PSQI)评分,比较 2 组的疗效及药物不良反应.结果 对照组 53例、观察组55 例完成研究.2 组治疗2 周、4 周、8 周后的HAMD17 评分、HAMA评分、SSI评分均较基线时明显降低(P均<0.05),且观察组治疗2 周、4 周、8 周后的HAMD17 评分、HAMA评分、SSI评分均明显低于同期对照组(P均<0.05).2 组治疗8 周后的PSQI总分和睡眠质量、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能评分均较基线时明显降低(P均<0.05),且观察组治疗8周后的PSQI总分和睡眠质量、睡眠时间、睡眠效率、催眠药物、日间功能评分均明显低于同期对照组(P均<0.05).观察组治疗 2 周、4 周、8 周后治疗总有效率均明显高于同期对照组[52.7%(29/55)、74.5%(41/55)、89.1%(49/55)比 39.6%(21/53)、69.8%(37/53)、81.1%(43/53),P均<0.05].观察组不良反应发生率明显低于对照组[5.4%(3/55)比 17.0%(9/53),P 均<0.05].结论 升阳益胃汤联合SSRI类药物治疗抑郁障碍起效更快,对抑郁症状、焦虑症状、躯体化症状以及睡眠质量的改善幅度更大,且有一定减少不良反应作用.
Abstract
Objective It is to observe the efficacy of decoction for raising Yang and replenishing stomach combined with 5-HT selective serotonin reuptake inhibitor(SSRI)in the treatment of depressive disorders.Methods A total of 120 pa-tients with depressive disorders treated as outpatients or inpatients in Hebei Mental Health Center from December 2020 to May 2022 were divided into control group and observation group according to the random number table method,with 60 ca-ses in each group.The control group was treated with SSRIs,and the observation group was treated with SSRIs combined with decoction for raising Yang and replenishing stomach,both groups were treated continuously for 8 weeks.The scores of Hamilton Depression Scale(HAMD17),Hamilton Anxiety Scale(HAMA),Somatization Symptom Inventory(SSI),and Pittsburgh Sleep Quality Index(PSQI)after 2,4 and 8 weeks of treatment,as well as the therapeutic efficacy and adverse effects of the medications were compared between the two groups.Results Fifty-three cases in the control group and 55 ca-ses in the observation group completed the study.The HAMD17 scores,HAMA scores,and SSI scores of the two groups af-ter 2,4,and 8 weeks of treatment were significantly lower than those at baseline(all P<0.05),and the HAMD17 scores,HAMA scores,and SSI scores of the observation group after 2,4,and 8 weeks of treatment were significantly lower than those of the control group at the same time period(all P<0.05).The total PSQI scores and scores of sleep quality,sleep duration,sleep efficiency,and sleep performance after 8 weeks of treatment were significantly lower than those at baseline in the two groups(all P<0.05),and the total PSQI score and scores of sleep quality,sleep duration,sleep effi-ciency,hypnotic drugs,and daytime function scores of the observation group after 8 weeks of treatment were significantly lower than those of the control group at the same period(all P<0.05).The total effective rate of treatment in the observa-tion group was significantly higher than that in the control group in the same period after 2,4,and 8 weeks of treatment[52.7%(29/55),74.5%(41/55),and 89.1%(49/55)VS.39.6%(21/53),69.8%(37/53),and 81.1%(43/53),all P<0.05].The incidence of adverse reactions in the observation group was significantly lower than that in the control group[5.4%(3/55)VS.17.0%(9/53),P<0.05].Conclusion Decoction for raising Yang and replenishing stomach combined with SSRI drugs has a faster onset of action in the treatment of depressive disorders,and is more effective in improving depressive symptoms,anxiety symptoms,somatization symptoms and sleep quality with less adverse reactions.
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