栝楼薤白半夏汤合温胆汤加减对冠心病合并抑郁症患者血清炎症因子和神经递质水平的影响  

Effects of Gualou Xiebai Banxia Decoction and Wendan Decoction on the level of serum inflammatory factors and neurotransmitters in coronary heart disease combined with depression patients

作　　者：王颖[1] 陈虎[2] 吕旺[1] 郭志[3] WANG Ying;CHEN Hu;LV Wang;GUO Zhi(Department of Traditional Chinese Medicine,Cangzhou Central Hospital,Hebei,Changzhou 061000,China;Office of Academic Research,Cangzhou Central Hospital,Hebei,Changzhou 061000,China;Human Resource Department,Cangzhou Central Hospital,Hebei,Changzhou 061000,China)

机构地区：[1]沧州市中心医院中医科,河北061000 [2]沧州市中心医院科研处,河北沧州061000 [3]沧州市中心医院人力资源部,河北沧州061000

出　　处：《中国中医基础医学杂志》2019年第12期1689-1692,共4页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：河北省中医药管理局科研计划项目(2018507)-中药治疗慢性心衰合并抑郁症的临床疗效观察;沧州市科技支撑计划项目(151302047)-基于"双心医学"的冠心病合并抑郁症发病机理及临床诊治研究。

摘　　要：目的:观察栝楼薤白半夏汤合温胆汤加减对冠心病合并抑郁症的疗效以及对血清白细胞介素(IL)-6、IL-1β、肿瘤坏死因子(TNF)-α以及去甲肾上腺素(NE)和5-羟色胺(5-HT)水平的影响。方法:128例冠心病合并抑郁症患者按随机数字表法分为对照组和观察组各64例。对照组给予劳拉西泮片每次1~2 mg、每日3次,观察组在对照组基础上给予栝楼薤白半夏汤合温胆汤加减每日1剂,每日2次,连续治疗2个月后比较2组汉密尔顿抑郁量表(HAMD)-17量表、抑郁自评量表(SDS)、HAMD量表因子评分、临床疗效、血清IL-6、IL-1β、TNF-α、NE、5-HT水平。结果:治疗2个月后观察组HAMD、SDS评分、HAMD量表各因子评分显著低于对照组,观察组总有效率(93. 65%)明显高于对照组,观察组血清IL-6、IL-1β、TNF-α水平显著少于对照组,NE和5-HT水平显著多于对照组。结论:栝楼薤白半夏汤合温胆汤加减治疗冠心病合并抑郁症疗效明显,抑制血清IL-6、IL-23、TNF-α水平以及上调NE和5-HT水平可能是其疗效途径之一。Objective:To investigate the efficacy of Gualou Xiebai Banxia decoction and Wendan decoction in treatment on depression after coronary heart disease and effect on serum levels of interleukin(IL)-6,IL-1β,tumor necrosis factor(TNF-α),norepinephrine(NE),and 5-hydroxytryptamine(5-HT).Methods:128 patients with depression after coronary heart disease were elected in our hospital and randomly divided into the control group and the observation group with 64 cases in each group according to random number table.Cases in the control group were orally treated with Lorazepam tablets(1~2 mg/time and tid).Based on the control group,the observation group was given with Gualou Xiebai Banxia decoction and Wendan decoction(1 dose/d and bid).After 2 months’treatment,scores of Hamilton’s depresion scale(HAMD)-17,self-rating depression scale(SDS),HAMD factors,the efficacy,and serum levels of IL-6,IL-1β,TNF-α,NE,5-HT were compared in two groups.Results:After 2 months’treatment,HAMD score,SDS,HAMD factors in the observation group were lower than those in the control group,the efficacy in the observation group(93.65%)was higher than control group,and serum levels of IL-6,IL-23,and TNF-αin the observation group were lower,while NE and 5-HT were higher than the control group.Conclusion:The efficacy of Gualou Xiebai Banxia decoction and Wendan decoction in treatment on depression after coronary heart disease is significant,inhibiting of serum levels of IL-6,IL-1β,TNF-αand up-regulation of NE and 5-HT may be one of the effective ways.

关 键 词：栝楼薤白半夏汤 温胆汤 冠心病 抑郁症 

分 类 号：R541.4[医药卫生—心血管疾病] R749.4[医药卫生—内科学]