中西医集成方案治疗中、重度抑郁症的临床观察  

Clinical Observation of Integrated Chinese-western Medicine Therapy in Treating Moderate or Severe Depression

作　　者：毕研蒙 温金峰 刘媛 赵晓华[1] 高婷婷 曲姗姗[1] 黄泳[1] 吕志平[1] BI Yan-Meng;WEN Jin-Feng;LIU Yuan;ZHAO Xiao-Hua;GAO Ting-Ting;QU Shan-Shan;HUANG Yong;LYU Zhi-Ping(School of Traditional Chinese Medicine,Southern Medical University,Guangzhou 510515 Guangdong,China;Guangdong Sanjiu Brain Hospital,Guangzhou 510510 Guangdong,China)

机构地区：[1]南方医科大学中医药学院,广东广州510515 [2]广东三九脑科医院,广东广州510510

出　　处：《广州中医药大学学报》2018年第5期774-779,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金："十二.五"国家科技支撑计划项目(编号:2014BAI10B07)

摘　　要：【目的】观察中西医集成方案治疗中、重度抑郁症的临床疗效。【方法】将160例原发性中、重度抑郁症患者随机分为试验组(中西医集成方案治疗组)和对照组(西药组),每组各80例。对照组给予艾司西酞普兰治疗12周,试验组在对照组的基础上,给予中药加味逍遥汤颗粒治疗12周,并于治疗开始后前4周进行针刺干预(以百会、印堂为主穴)。在治疗前及治疗后第2、4、6和12周分别用汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)和抗抑郁药副反应量表(SERS)进行评分,并随访治疗结束后1年内的复发情况,比较试验组与对照组的临床疗效。【结果】(1)试验组和对照组各脱落7例,最终146例患者纳入研究。(2)治疗12周后,试验组的总有效率为79.45%,对照组为63.01%,试验组的疗效明显优于对照组(P<0.05)。(3)治疗开始后第2、4、6和12周,试验组和对照组的HAMD评分及其焦虑躯体化因子评分、睡眠因子评分、迟缓因子评分和SDS评分均较治疗前显著降低(P<0.001),且试验组均显著低于对照组(P<0.001)。(4)试验组治疗开始后第2周、4周、6周和12周的SERS评分均显著低于对照组(P<0.001)。(5)试验组和对照组1年内的复发率分别为24.14%和43.49%,试验组的复发率显著低于对照组(P<0.05)。【结论】中西医集成方案对中、重度原发性抑郁症的总体疗效及对HAMD各因子的改善效果均显著优于单纯西药治疗,安全性也优于单纯西药治疗,且1年内的复发率低于单纯西药治疗。Objective To investigate the curative effect of integrated Chinese-western medicine therapy in treating moderate or severe depression. Methods A total of 160 patients with moderate or severe primary depression were randomly allocated into test group（receiving integrated Chinese-western medicine therapy）and control group（receiving western medicine therapy）, 80 cases in each group. The both groups received escitalopram for 12 weeks, additionally, the test group received modified Xiaoyao Decoction Granules for 12 weeks and received acupuncture mainly on Baihui and Yintang（EX-HN3）4 weeks before treatment. Before treatment and at post-treatment week 2,4,6,12,the clinical curative effect was evaluated by Hamilton Depression（HAMD）Rating Scale, Self-rating Depression Scale（SDS）and Asberg Rating Scale for Side Effects（SERS）. Recurrence was followed up within one year after treatment, and the curative effect in the test group and control group was compared. Results（1）Seven cases dropped out from the test group and control group,respectively. Eventually,a total of 146 cases were enrolled in the experiment.（2）After treatment for 12 weeks,the total effective rate was 79.45% in the test group,and was 63.01% in the control group,the therapeutic effect in the test group being superior to that in the control group（P〈0.05）.（3）At post-treatment week 2,4,6,12,the HAMD scores,the scores of anxious somatization, sleeping and retardation factors, and the SDS scores were significantly decreased in the two groups as compared with those before treatment（P〈0.001）,and the above indexes in the test group were lower than those in the control group（P〈0.001）.（4）The scores of SERS was lower in the test group than that in the control group at post-treatment week 2,4,6 and 12（P〈0.001）.（5）The recurrence rate within one year in the test group（24.14%）was lower than that in the control group（43.49%）,the difference being significant（P〈0.05）. Conclusion Integrated Chinese-

关 键 词：抑郁症 中西医集成方案 针刺 百会 印堂 加味逍遥汤颗粒 艾司西酞普兰 HAMD评分 SDS评分 SERS评分 

分 类 号：R277.7[医药卫生—中医学]