扶正解郁汤治疗乳腺癌术后抑郁症肝郁脾虚型的临床观察  

Clinical observation on Fuzheng jieyu decoction in treatment of hepatic stagnation and spleen deficiency type depression after breast cancer operation

作　　者：金津津[1] 余志怡[1] 徐斌[1] 

机构地区：[1]浙江大学金华医院中医科,浙江金华321000

出　　处：《中国现代医生》2016年第16期123-126,共4页China Modern Doctor

基　　金：浙江省中医药科研基金项目(2012ZB166)

摘　　要：目的对比研究中药扶正解郁汤和西药阿普唑仑对乳腺癌术后抑郁症肝郁脾虚型患者的疗效和安全性。方法根据随机、对照的原则，2013年9月～2015年3月期间从我院肿瘤科、放疗科及中医科筛查并招募符合标准的乳腺癌术后抑郁症肝郁脾虚型患者82例，其中41例随机分配至扶正解郁汤组（治疗组），另外41例分配至阿普唑仑组（对照组）。研究时间持续10周，主要观察指标包括汉密尔顿抑郁量表（HAMD，24条目）、中医证候因子及T细胞淋巴亚群。结果扶正解郁汤对乳腺癌抑郁症肝郁脾虚型患者焦躯化、认知障碍、睡眠障碍及HAMD总分因子的改善优于阿普唑仑，差异有统计学意义（t=17．450、7．470、25．049、18．178，P〈0．01）。扶正解郁汤对乳腺癌抑郁症肝郁脾虚型患者的中医症候积分治疗总有效率为82．9％，相比于阿普唑仑组（51．2％），差异有统计学意义（x2=9．332，P=0．002）。免疫指标方面，治疗组CD4＋、CD47CD8＋明显升高，与对照组比较差异有统计学意义（t=11．253、5．931，P〈0．01）。结论扶正解郁汤在改善乳腺癌术后抑郁症肝郁脾虚型患者的抑郁情绪和免疫功能方面有明显优势，且不良反应少。Objective To compare the efficacy and safety of Fuzheng Jieyu decoction and alprazolam in treatment of hepatic stagnation and spleen deficiency type depression after breast cancer operation. Methods 82 patients with hep- atic stagnation and spleen deficiency type depression after breast cancer operation treated in our hospital from Septem- ber 2013 to March 2015 were selected and randomly and equally divided into the treatment group （Fuzheng Jieyu de- coction group） and the control group （alprazolam group）. The study lasted for 10 weeks and main outcome measures in- cluded Hamilton＇s Depression Scale （24 items）, TCM syndrome factors and T lymphocytes subgroup. Results The im- provement of Fuzheng Jieyu decoction on anxiety somatization, cognitive disorder, sleep disorder, and HAMD total score factors in patients with hepatic stagnation and spleen deficiency type depression after breast cancer operation was more significant than that of alprazolam （t=17.450, 7.470, 25.049, and 18.178, P〈0.01）. The overall response rate of Fuzheng Jieyu decoction on TCM syndrome factors was 82.9%, which was significantly higher than that of alprazolam（51.2%, X2= 9.332,P=0.002）. As to immune indexes, the levels of CD4＋ and CD4＋/CD8＋ were significantly higher in the treatment group than in the control group （t=1 1.253 and 5.931; P〈0.01）. Conclusion Fuzheng Jieyu decoction has obvious advan- tages in reliving depression and improving immunity of patients with hepatic stagnation and spleen deficiency type de- pression after breast cancer operation and the incidence of adverse reaction is low.

关 键 词：扶正解郁汤 乳腺癌 抑郁症 肝郁脾虚型 

分 类 号：R255.2[医药卫生—中医内科学]