5-羟色胺再摄取抑制剂合并甘麦大枣汤治疗抑郁症的随机对照研究  

A randomized controlled study of selective serotonin reuptake inhibitors combined with Ganmai Dazao decoction in the treatment of depression

作　　者：朱文娴[1] 王群松[1] 季向东[1] 袁国桢[1] 

机构地区：[1]南京医科大学附属无锡精神卫生中心,江苏214151

出　　处：《临床精神医学杂志》2017年第3期171-174,共4页Journal of Clinical Psychiatry

基　　金：无锡市科技支撑计划项目(CSE01N1233)

摘　　要：目的:探讨5-羟色胺再摄取抑制剂(SSRIs)联合甘麦大枣汤的抗抑郁增效作用以及对临床用药的影响。方法:将68例抑郁症患者随机分为研究组(n=33)和对照组(n=35),对照组单用一种SSRIs治疗,研究组在此基础上联用甘麦大枣汤治疗;分别于治疗前及治疗6周后对两组采用汉密尔顿抑郁量表(HAMD-24)、及治疗后采用Asberg抗抑郁药不良反应量表(SERS)进行评定;比较两组疗效及不良反应,以及两组使用SSRIs及苯二氮类药物(BDZ)的用量差异。结果:治疗前HAMD评分两组间差异无统计学意义(P>0.05);治疗6周,两组HAMD总分及各因子评分较治疗前显著降低(P均<0.05),且研究组HAMD总分及焦虑/躯体化、睡眠障碍、绝望感因子分显著低于对照组(F=10.90,9.302,8.698,7.940;P均<0.01)。研究组SSRIs平均使用强度及BDZ平均使用人次均显著低于对照组(t=-2.071,P=0.042;t=-3.44,P=0.001)。治疗末两组SERS评分差异无统计学意义(t=-0.889,P=0.377)。结论:SSRIs联合甘麦大枣汤抗抑郁治疗具有增效作用,并可降低SSRIs及BDZ的用量,且不增加药物不良反应。Objective：To explore the influence of Ganmai Dazao （GMDZ） decoction on the efficacy and usage of selective serotonin reuptake inhibitors （SSRIs） for the treatment of major depressive disorder （MDD）. Method：Sixty-eight patients with MDD were randomly allocated into two groups, of whom 33 to the trim group （treated with Ganmai Dazao Decoction combined with SSRIs） and 35 to the control group （ treated with SS- RIs）. The Hamilton depression rating scale （HAMD ,24 items version） was evaluated for each participant at the baseline and after 6-week treatment. The average using density （AUD） of SSRIs, as well as the average using frequency （AUF） of benzodiazepines （BDZ） in both groups was calculated. The Asberg rating scale for side effects （SERS） was assessed at the end of 6-week treatment. Results：There was no difference in either total HAMD score or any factor score between the two groups at the baseline （ all P 〉 0.05 ）. After 6-week treatment, all these scores decreased significantly in both groups （ all P 〈 0.05）, and the total HAMD score as well as the ＂anxiety/somatization＂ ,＂ sleep disorder＂ and ＂ hopelessness＂ factor scores of the trial group was significantly lower than that of the control group （ F = 10.90,9. 302,8. 698,7. 940 ; all P 〈 0. 05 ）. Both the AUD of SSRIs and the AUF of BDZ were significantly lower than those of the control group （ t = - 2. 071, P = 0. 042 ; t = -3.44,P = 0. 001）. There was no significant difference in the SERS scores between the two groups （t = - 0. 889,P = 0. 377）. Conclusion： GMDZ decoction has a synergistic effect on SSRIs for the treatment of MDD without increasing side effects, and the combination use of GMDZ decoction may contribute to reduce the dosages of SSRIs and BDZ.

关 键 词：甘麦大枣汤 抑郁症 5-羟色胺再摄取抑制剂 苯二氮类药 

分 类 号：R749.4[医药卫生—神经病学与精神病学]