圣·约翰草提取物对冠状动脉搭桥术后患者抑郁心理及心功能的康复作用 随机分组、安慰剂对照、盲法评估  

Rehabilitation effect of San John's Wort extract on depression and myocardial function after coronary artery bypass grafting:A randmcized grouping, placebo-control and blind evaluation

作　　者：李咏梅[1] 李国毅[2] 王晓蕾[3] 于玲范[1] 

机构地区：[1]哈尔滨医科大学附属第二医院心外科,黑龙江省哈尔滨市150086 [2]黑龙江省医院神经内科,黑龙江省哈尔滨市150086 [3]哈尔滨医科大学附属第二医院超声科,黑龙江省哈尔滨市150086

出　　处：《中国临床康复》2005年第28期38-39,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:观察圣·约翰草提取物对冠状动脉搭桥术后患者抑郁心理的治疗效果与心功能康复之间的关系。方法:选取2003/2004哈尔滨医科大学附属第二医院收治的87例非体外循环冠脉搭桥术患者,年龄50～80岁,汉密顿抑郁量表17项>18分,抽签法随机分为治疗组和对照组,分别服用圣·约翰草提取物或安慰剂300mg/次,3次/d口服,疗程均为6周。安慰剂和药物外观相同,盲法服药,但对其治疗方案知情并签同意书。于治疗前及治疗后2,4,6周应用汉密顿抑郁量表评分(采用0～4分的5级评分法:0:无,1:轻度,2:中度,3:重度,4:很重)及减分率评定抗抑郁疗效。患者心功能情况以彩色超声多普勒二尖瓣口血流图和左室流出道血流图计算Tei指数评价。结果:治疗过程中治疗组脱落2例,对照组脱落3例,进入结果分析的治疗组43例,对照组39例。①两组在各治疗时期的汉密顿抑郁量表评分及减分率比较:治疗后2,4,6周治疗组汉密顿抑郁量表评分均低于对照组(18.1±5.5,24.5±6.5;13.0±4.0,21.2±5.3;8.3±4.1,19.3±6.6,P<0.01或P<0.05),减分率高于对照组(34.1±18.9)%,(9.8±3.9)%;(54.9±24.3)%,(21.6±10.4)%;(62.7±19.4)%,(28.3±7.8)%,P<0.01。②两组在各治疗时期Tei指数比较:治疗后4,6周治疗组的Tei指数低于对照组(0.52±0.15,0.66±0.08;0.42±4.10,0.61±0.11,P<0.01)。③两组不良事件和副反应比较:治疗组有8例患者出现轻度皮肤瘙痒、口干、头晕,对照组有4例有轻度口干,均能耐受或自行缓解。结论:圣·约翰草提取物对冠状动脉搭桥术后患者抑郁情绪具有明显的改善效果,同时提高心功能恢复的速度和效果也明显优于安慰剂对照组。AIM： To observe the effect of San John＇ Wort extract on depression of patients underwent coronary artery bypass grafting and the relationship with recovery of ventricular function.METHODS： Totally 87 patients receiving coronary artery bypass grafting in the Second Affiliated Hospital of Garbin Medical University from 2003 to 2004, aged 5 to 80 years with the Hamilton Depression Rating Scale for Depression （HAMD） Score 〉18 scores were selected and were randomized into the treatment group and control group. They were treated with San John＇ Wortextract or placebo orally at 300 mg per time daily, three times a day for 6 weeks. The placebo was the same from the outer appearance, and blind administration was used. The informed consent of scheme was obtained.HAMD（0： no; 1： slight; 2： moderate＇,3： severe; 4： very severe） and reductive rate were used to evaluate the curative effect of anlidepression before treatment and 2, 4 and 6 weeks after treatment. Cardiac function was evaluated with with Tei index that was computed by blood stream picture of left outflow tract and mitral inflow with transthoracic Doppler echocardiography.RESULTS： During therapy, there were 2 cases loss in the treatment group, 3 in the control group. Therefore, there were 43 cases in the treatment group, 39 cases in the control group entering the result analysis.①HAMD scores and reductive rate of the two groups was decreased 2, 4 and 6 weeks in the treatment group than that in the control group （18.1±5.5,24.5±6.5;13.0±4.0,21.2±5.3;8.3±4.1,19.3±6.6,P 〈 0.01 or P 〈 0.05）,and reductive rate was higher in the treatment group than that in the control group [（34.1±18.9）%, （9.8±3.9）%; （54.9±24.3）%, （21.6±10.4）%;（62.7±19.4）%, （28.3±7.8）%,P 〈 0.01].②Tei index in the 4-week and 6-week treatment group was higher than that in the control group（0.52±0.15,0.66±0.08 ; 0.42±4.10,0.61±0.11,P 〈 0.01 ）.③ Comparison of the adverse events and side effect between the two groups�

关 键 词：冠状动脉疾病 抑郁 功能恢复 

分 类 号：R749.7[医药卫生—神经病学与精神病学]