文拉法辛防治不同中医证型重性抑郁障碍效果评价  

Efficacy of venlafaxine on prophylaxis and treatment of different TCM syndrome types of major depressive disorder

作　　者：刘兰英[1] 骆利元 朱春青[1] 王佩蓉[1] 杨春玉[1] 宁芳 LIU Lan-ying;LUO Li-yuan;ZHU Chun-qing;WANG Pei-rong;YANG Chun-yu;NING Fang(Department of Mental Health, Tongde Hospital of Zhejiang Province, Hangzhou , Zhejiang 310012, China)

机构地区：[1]浙江省立同德医院精神卫生科,浙江杭州310012 [2]浙江中医药大学

出　　处：《预防医学》2018年第5期459-462,共4页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：国家自然科学基金项目(81403502)

摘　　要：目的评价文拉法辛对不同中医证型重性抑郁障碍的防治效果。方法选取2015年1月—2017年5月在浙江省立同德医院就诊的30例肝郁气滞证型和25例心脾两虚证型重性抑郁障碍患者,采用文拉法辛治疗,采用汉密尔顿抑郁量表(HAMD)和抗抑郁药副反应量表(SERS)比较两组患者治疗效果。结果两组患者在年龄、性别、文化程度、家族史、平均病程及治疗前HAMD评分比较,差异均无统计学意义(P>0.05)。治疗后,两组的HAMD评分均随观测时间推移逐渐下降;肝郁气滞证组治疗第2、4、6周末的HAMD评分均低于心脾两虚证组(均P<0.001)。治疗6周后,肝郁气滞证组焦虑/躯体化、认知障碍、迟缓及绝望感4个因子治疗前后评分差值均大于心脾两虚证组(P<0.05)。肝郁气滞证组SERS总分为(3.60±4.98)分,心脾两虚证组SERS总分为(3.16±2.93)分,差异无统计学意义(P>0.05)。结论文拉法辛对肝郁气滞、心脾两虚证型重性抑郁障碍均有效,但对肝郁气滞证型重性抑郁障碍疗效更好。Objective To explore the efficacy of venlafaxine in prophylaxis and treatment of different TCM syndrome types of major depressive disorder. Methods From January 2015 to May 2017, thirty stagnation of liver-qi type and twenty-five insufficiency of heart and spleen type of patients with depression were recruited and treated by venlafaxine. The treatment course was six weeks. The efficacy was evaluated by Hamilton Depression Scale（HAMD） and Rating Scale for Side Effects（SERS）.Results There were no statistically significant differences in age,gender,education,family history,course of the disease and HAMD at baseline between the stagnation of liver-qi type group and the insufficiency of heart and spleen type group（P0.05）.The HAMD scores of the two groups were significantly decreased at two,four,six weeks after venlafaxine treatment;the HAMD scores of stagnation of liver-qi type group were significantly lower than that of insufficiency of heart and spleen type group at the second week, the fourth week and the sixth week（all P〈0.001）. After six weeks of treatment, the scores of anxiety or somatization,cognitive impairment,retardation and hopelessness factors decreased more in the stagnation of liver-qi type group than that in the insufficiency of heart and spleen type group（P〈0.05）. The scores of SERS have no statistically significant difference between the two groups（3.60±4.98 vs.3.16±2.93）（P〉0.05）. Conclusion Venlafaxine has some treatment effect both on the stagnation of liver-qi type and the insufficiency of heart and spleen type of patients with depression,but better in the stagnation of liver-qi type.

关 键 词：抑郁障碍 肝郁气滞证 心脾两虚证 文拉法辛 效果评价 

分 类 号：R749.4[医药卫生—神经病学与精神病学]