摘要
[目的]观察越鞠加味方对血管性抑郁患者的临床疗效及对血皮质醇(cortisol,CORT)水平的影响,探讨其抗抑郁作用的机制。[方法]纳入2014年6月至2018年1月于浙江中医药大学附属金华中医医院神志病科就诊的血管性抑郁患者65例,采用随机数字表法分为观察组和对照组,观察组33例采用越鞠加味方加艾司西酞普兰片治疗,对照组32例采用艾司西酞普兰片治疗,疗程1个月。评测两组患者治疗前后汉密尔顿抑郁量表(Hamilton depression scale,HAMD)-24分值,以HAMD减分率来评定两组疗效;测定治疗前后患者8AM CORT、4PM CORT水平反映下丘脑-垂体-肾上腺(hypothalamus-hypophysis-adrena, HPA)轴功能状态。[结果]两组患者治疗后HAMD分值均明显低于治疗前(P<0.01),两组治疗后HAMD分值比较,观察组低于对照组(P<0.05)。观察组疗效优于对照组(P<0.05)。两组患者治疗后8AM CORT、4PM CORT水平均明显低于治疗前(P<0.01);治疗后两组间比较,观察组8AM CORT水平低于对照组(P<0.01),而4PM CORT无统计学差异(P>0.05)。[结论]越鞠加味方对血管性抑郁有较好的抗抑郁作用,其机制可能与降低HPA轴高激活状态有关,尤其是对CORT晨峰的抑制作用更明显。
[Objective]To observe clinical curative effect of Yueju Jiawei prescription on vascular depression(VD),and the level of blood cortisol (CORT), explore its possible anti-depression mechanism.[Methods]Sixty five VD patients were selected in department of sense of Jinhua Traditional Chinese Medicine Hospital affiliated to Zhejiang Traditional Chinese Medicine University,from June 2014to January 2018.They were assigned to two groups according to random number table.Thirty three cases in the observation group was treated with the Yueju Jiawei prescription and escitalopram;32cases in the control group was treated with escitalopram,both of the two groups take medicine one month being a therapeutic course.Hamilton depression scale(HAMD-24)was evaluated before and after the treatment of the two groups,and the efficacy of two groups were evaluated with the HAMD reduction rate.The level of 8AM and 4PM blood CORT reflects the state of HPA axis.[Results]HAMD score of the two group was significantly lower than before treatment(P<0.01).After treatment,compared the HAMD scores between the two groups,observation group was lower than control group(P<0.05),and the curative effect of observation group was better than control group(P<0.05).The levels of 8AM CORT and 4PM CORT in the two groups were significantly lower than those before treatment(P<0.01).After treatment,the levels of 8AM CORT in observation group were lower than those in control group(P<0.01), but there was no significant difference in 4PM CORT between the two groups(P>0.05).[Conclusion]Yueju Jiawei prescription has a good antidepressant effect on vascular depression,and its mechanism may be related to decreasing the high activation of HPA axis,especially the high morning peak.
作者
吕莉君
高丽
张梦婷
胡浩宇
晏程远
施海燕
LYU Lijun;GAO Li;ZHANG Mengting(Jinhua Hospital of Traditional Chinese Medicine,Affiliated to Zhejiang Chinese Medical University,Zhejiang,Jinhua(321000),China)
出处
《浙江中医药大学学报》
CAS
2018年第11期937-940,共4页
Journal of Zhejiang Chinese Medical University
基金
金华市中医药科学技术研究计划项目(2014-4-020)~~
