摘要
目的 探讨归脾汤联合艾司西酞普兰治疗抑郁症的疗效及对肠道菌群的影响。方法 选取2021年12月至2022年7月宁波大学附属第一医院收治的78例心脾两虚型抑郁症患者,按随机数字表法分为3组,归脾汤联合抗抑郁药组使用归脾汤联合草酸艾司西酞普兰治疗,益生菌联合抗抑郁药组使用双歧三联杆菌活菌胶囊联合草酸艾司西酞普兰治疗,单用抗抑郁药组使用草酸艾司西酞普兰治疗,每组各26例,疗程8周。评估治疗前及治疗第1、2、4、8周汉密尔顿抑郁量表(HAMD-17)评分和汉密尔顿焦虑量表(HAMA)评分,并行16S rDNA肠道菌群检测。另以本院30名体检健康者为对照组。结果 归脾汤联合抗抑郁药组在第2、4、8周时疗效均优于单用抗抑郁药组(均P<0.05)。治疗第2、4、8周,归脾汤联合抗抑郁药组HAMD-17评分显著低于单用抗抑郁药组,HAMA评分显著低于益生菌联合抗抑郁药组及单用抗抑郁药组(均P<0.05)。Alpha多样性分析显示,治疗8周后归脾汤联合抗抑郁药组Chao1指数和物种丰富度指数均显著高于治疗前(均P<0.05)。Beta多样性分析显示,对照组肠道菌群物种多样性均显著大于3个病例组(均P<0.05);治疗后3组肠道菌群物种多样性均显著大于治疗前(均P<0.05)。3组变形杆菌门、肠杆菌科、埃希-志贺菌属、克雷伯菌属等菌群丰度均显著高于对照组,拟杆菌门、梭菌属等丰度均显著低于对照组(均P<0.05)。相比治疗前,归脾汤联合抗抑郁药组治疗后厚壁菌门、颤螺菌科、瘤胃球菌科、梭菌属等菌群丰度均显著升高,变形杆菌门、肠杆菌科、克雷伯菌属、埃希-志贺菌属等丰度均显著降低(均P<0.05);单用抗抑郁药组治疗后丁酸球菌科、粪球菌属、颤螺菌属等丰度均显著升高,丹毒丝菌科丰度显著降低(均P<0.05);益生菌联合抗抑郁药组治疗后普雷沃菌属、粪球菌属、梭菌属等丰度均显著升高,艾克曼菌科、肠�
Objective To investigate the efficacy of Guipi Decoction combined with escitalopram oxalate tablets in the treatment of major depressive disorder(MDD)and its effect on intestinal flora.Methods Senventy eight MDD patients with traditional Chinese medicine(TCM)syndrome of heart and spleen deficiency were enrolled in the First Affiliated Hospital of Ningbo University between December 2021 to July 2022,and 30 healthy individuals served as a control group.Patients were randomly assigned into three groups with 26 cases in each group:group A received Guipi Decoction and escitalopram oxalate tablets,group B received bifid triple viable and escitalopram oxalate tablets,and group C received escitalopram oxalate tablets alone.All groups underwent an 8-week treatment course.Hamilton Depression Scale(HAMD-17)scores and Hamilton Anxiety Scale(HAMA)scores were evaluated,and 16S rDNA intestinal flora tests were performed before treatment and at week 1,2,4,and 8 of treatment.Results The group A had better clinical response at weeks 2,4,and 8 of treatment compared to the group C(all P<0.05).At weeks 2,4,and 8 of treatment,the group A showed a significant decrease in HAMD-17 scores compared to the group C,and a significant decrease in HAMA scores compared to the groups B and C(all P<0.05).Alpha diversity,as measured by Chao1 and observed species index,increased in the group A after 8 weeks of treatment compared to that before treatmetn(all P<0.05).Beta diversity analysis showed that healthy subjects had greater species diversity compared to MDD patients,and all three groups had increased diversity after treatment(all P<0.05).Compared to healthy subjects,the abundance of Proteobacteria,Enterobacteriaceae,Escherichia-Shigella,Klebsiella in MDD patients increased(all P<0.05),while Bacteroidota,Clostridia decreased relatively(all P<0.05).The abundance of Firmicutes,Oscillospiraceae,Ruminococcaceae,and Clostridia in the group A increased from the baseline(all P<0.05),while Proteobacteria,Enterobacteriaceae,Klebsiella,and Escherichia-Shi
作者
林晨
戴霓
胡洁琼
邬丹娟
胡昕昕
季蕴辛
LIN Chen;DAI Ni;HU Jieqiong;WU Danjuan;HU Xinxin;JI Yunxin(Department of Psychosomatic Medicine,the First Affiliated Hospital of Ningbo University,Ningbo 315000,China)
出处
《浙江医学》
CAS
2024年第19期2044-2050,共7页
Zhejiang Medical Journal
基金
浙江省中医药科技计划项目(2021ZB260、2020ZB219)
浙江省医药卫生科技计划项目(2023KY1064)。
关键词
抑郁症
心脾两虚
归脾汤
肠道菌群
Major depressive disorder
Heart and spleen deficiency
Guipi Decoction
Intestinal flora
