归脾汤加减对高血压病合并抑郁症患者血压及其生活质量的影响  

Effect of Modified Guipi Decoction on Blood Pressure and Quality of Life in Hypertension Patients Complicated Depression

作　　者：李海聪[1] 杨毅玲[2] 杨学青[1] 李求兵[1] 王燕[1] 朱赫[1,3] 田心[1] 陈晓光[1] 

机构地区：[1]中日友好医院老年病科,北京100029 [2]北京中医药大学诊断教研室,北京100029 [3]中国中医科学院广安门医院,北京100053

出　　处：《中国中西医结合杂志》2016年第2期172-178,共7页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：中日友好医院院级科研基金资助项目(No.2010-MS-37)

摘　　要：目的研究归脾汤加减对高血压病合并抑郁症患者血压及其生活质量的影响。方法将245例高血压病合并抑郁症患者随机分为治疗组(125例)和对照组(120例),最终纳入合格病例治疗组为117例,对照组为111例,分别给予归脾汤加减的中药汤剂和西药舍曲林片治疗,疗程均为4周。观察两组患者治疗前后不同时期患者血压的变化、1 7项汉密尔顿抑郁量表(Hamilton Depression Scale-17,HAMD-17)、汉密尔顿焦虑量表(Hamilton Anxiety Rating Scale,HAMA)、健康状况问卷(Short-Form36 Health Survey Questionnaire,SF-36)、治疗药物不良反应量表(Treatment Emergent Symptom Scale,TESS)等评分的变化,以判断两组的临床疗效。结果(1)与本组治疗前比较,治疗组2周后收缩压谷值和舒张压谷值均降低,对照组2周后收缩压谷值降低,舒张压谷值3周后降低(均P<0.05,P<0.01),两组在治疗第2、3、4周时收缩压谷值下降值和舒张压谷值下降值均明显大于其第1周的下降值(P<0.05,P<0.01)。与对照组同期比较,在治疗第4周时,治疗组收缩压谷值下降明显(P<0.01),收缩压谷值下降值和舒张压谷值下降值均大于对照组(P<0.01)。治疗组目标血压达标率为60.7%(71/1 17),对照组为42.3%(47/1 1 1),两组比较,治疗组优于对照组(χ~2=7.6781,P<0.01)。(2)与本组治疗前比较,两组治疗后第2、3、4周HAMD-17评分均降低(P<0.01),与对照组比较,治疗组治疗后第4周HAMD-17评分降低更明显,减分差值增大(均P<0.05);有效率达79.5%(93/1 17),对照组有效率为66.7%(74/1 1 1),治疗组高于对照组(χ~2=4.7741,P<0.05)。(3)与本组治疗前比较,两组治疗后第1、2、3、4周HAMA分值均明显降低(P<0.05,P<0.01);与对照组比较,治疗组治疗后第3、4周HAMA分值降低,减分差值增大(P<0.05,P<0.01)。(4)治疗4周后,除对照组生理机能外,两组SF-36总分及各因子评分均明显升高(P<0.05,P<0.01),治疗组改善生理机能、生理职能、总体健康、情感职Objective To study the effect of Modified Guipi Decoction（MGD） on blood pressure and quality of life（QOL） in hypertension patients complicated depression.Methods Totally 245 hypertension patients complicated depression were randomly assigned to the treatment group（125 cases,treated with MGD） and the control group（120 cases,treated with Sertraline）.Final recruited qualified patients were 117 cases in the treatment group and 111 cases in the control group.The therapeutic course for all was 4 weeks.Changes of blood pressure,scores rated by Hamilton Depression Scale-17（HAMD-17）,Hamilton Anxiety Rating Scale（HAMA）,short-form 36 health survey questionnaire（SF-36）,and Treatment Emergent Symptom Scale（TESS） were observed before and after treatment,thereby judging their efficacies.Results（1） Compared with before treatment in the same group,systolic and diastolic blood pressures significantly decreased in the treatment group after 2 weeks of treatment;systolic blood pressure significantly decreased after 2 weeks of treatment and diastolic blood pressure significantly decreased after 3 weeks of treatment in the control group（all P 〈0.05,P 〈0.01）.Decreased valley values of systolic and diastolic blood pressures at week 2,3,and 4 after treatment were obviously higher than those at week 1 after treatment in the two groups（P 〈0.05,P 〈0.01）.Compared with the control group at week 4 after treatment,valley value of systolic blood pressure obviously decreased in the treatment group（P 〈0.01）.Decreased valley values of systolic and diastolic blood pressures in the treatment group were higher than those of the control group（P 〈0.01）.The success rate of target blood pressure was 60.7%（71/117 cases） in the treatment group and 42.3%（47/111 cases） in the control group,with statistical difference（x^2 =7.6781,P 〈0.01）.（2） Compared with before treatment in the same group,the score of HAMD-17 at week 2,3,and 4 after treatment all decreased in the two groups（P

关 键 词：归脾汤 高血压病 抑郁症 生活质量 

分 类 号：R259[医药卫生—中西医结合] R277.7[医药卫生—中医内科学]