摘要
目的：观察和探究舒肝颗粒在选择性5-羟色胺再摄取抑制剂（SSRIs）应用中的减毒增效作用,以期减少SSRIs不良反应、提高用药依从性和抗抑郁效果。方法：选取2014年3月—2016年9月216例抑郁症患者,采用随机数字表法,按照1∶1比例将其随机分为观察组和对照组（每组108例）。对照组患者采用SSRIs抗抑郁治疗,观察组加用舒肝颗粒。比较两组患者HAMD及HAMA量表评分、治疗前后神经递质水平（5-HT、NE和DA）和SSRIs不良反应、苯二氮卓类药物使用情况。结果观察组HAMD及HAMA临床痊愈率（9.26%、8.33%）、显效率（30.56、22.22%）和总有效率（85.19%、78.70%）高于对照组,差异均有统计学意义,P50%率（48.15%、75.00%）均高于对照组,差异有统计学意义,P〈0.05。结论舒肝颗粒在SSRIs应用中具有减毒增效的作用,且本研究进一步丰富了舒肝颗粒与5-HT水平的关系,促进了中医理论的发展与完善,为舒肝颗粒的临床应用提供了参考依据,值得进一步研究。
Objective： To observe and explore the attenuating and synergistic effect of Shugan Granules in the application of selective serotonin reuptake inhibitors（ SSRIs）,with a view to reducing the toxic side effects of SSRIs and improving drug compliance and antidepressant effects. Methods： From March 2014 to September 2016,216 patients with depression were selected and randomized into the observation group and the control group（ 108 cases in each group） according to the ratio of 1 ∶ 1. The patients in the control group were treated with SSRIs and the Shugan Granules were added to the observation group. The levels of neurotransmitter（ 5-HT,NE and DA）,side effects of SSRIs,and the use of benzodiazepines before and after treatment were compared between the two groups in terms of the evaluation of HAMD and HAMA.Results： The clinical cure rates of HAMD and HAMA in observation group（ 9. 26%,8. 33%）,markedly effective rate（ 30. 56,22. 22%） and total effective rate（ 85. 19%,78. 70%） were significantly higher than those in control group,P 0. 05. After treatment,the levels of 5-HT（ 1095. 20 ± 252. 00） mg/L,NE（ 594. 00 ± 167. 00） ng/L and DA（ 35. 10 ±5. 60） μg/m L in the observation group were significantly higher than those in the control group,P 〈0. 05. Behavioral Toxicity（ 22. 22%）,the nervous system（ 0. 93%）,the autonomic nervous system（ 2. 78%）,the digestive system（ 7. 41%）,the cardiovascular system（ 4. 63%）,the blood system（ 0. 00%） and other side effects（ 2. 78%） were lower than those of the control group and the difference was statistically significant（ P 〈0. 05）. The incidence of insomnia（ 21. 30%,68. 52%） and side effects of digestive system（ 7. 41%,37. 04%） were higher than those of other groups in the same group and the difference was statistically significant（ P 〈0. 05）. At the end of the first course,the rates of discontinuation of benzodiazepines（ 44. 44%,57. 41%） and daily dose reductions 50%（ 48. 15%,75. 00%�
作者
谢正
张志娟
于俊丽
张香芝
XIE Zheng;ZHANG Zhijuan;YU Junli;ZHANG Xiangzhi(Department of Clinical Psychology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan, Chin)
出处
《中华中医药学刊》
CAS
北大核心
2018年第4期852-855,共4页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金项目(81371494)
