乌梅丸联合帕罗西汀治疗肝阳虚型抑郁症的疗效及对患者Th17/Treg平衡、相关细胞因子表达的影响  

Efficacy of Wumei Pills Combined with Paroxetine in the Treatment of Depression of Liver Yang-Deficiency Type and its Effect on Th17/Treg Balance and Expression of Related Cytokines

作　　者：李生菊 葛鑫宇[2] 王璐洁 潘永花 LI Shengju;GE Xinyu;WANG Lujie;PAN Yonghua(Dept. of Traditional Chinese Medicine and Western Medicine, the Third People's Hospital of Qinghai, Qinghai Xining 810007, China;Dept. of Traditional Chinese Medicine, Affiliated Brain Hospital of Guangzhou Medical University/Guangzhou Hui'ai Hospital, Guangdong Guangzhou 510370, China)

机构地区：[1]青海省第三人民医院中西医科,青海西宁810007 [2]广州医科大学附属脑科医院/广州惠爱医院中医科,广东广州510370

出　　处：《中国医院用药评价与分析》2020年第5期536-539,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：青海省卫生计生委科研课题(No.2018-wjzdx-39)。

摘　　要：目的:探讨乌梅丸联合帕罗西汀治疗肝阳虚型抑郁症的临床疗效及其对患者外周血辅助性T细胞17型(Th17)/调节性T细胞(Treg)平衡及相关细胞因子表达的影响。方法:选取2017年5月至2019年8月广州惠爱医院收治的肝阳虚型抑郁症患者92例,采用简单随机数字表法将其分为观察组和对照组,每组46例。观察组患者给予乌梅丸+帕罗西汀治疗,对照组患者则单独使用帕罗西汀治疗,所有患者均连续治疗8周。观察两组患者的临床疗效,治疗前及治疗第2、4、8周末时的17项汉密尔顿抑郁量表(Hamilton rating scale-17 for depression,HAMD-17)评分,治疗第1、2、4及8周末时的副反应量表(treatment emergent symptom scale,TESS)评分,治疗前后血清白细胞介素17(IL-17)、白细胞介素10(IL-10)水平以及外周血Th17/Treg细胞的表达水平。结果:观察组患者的总有效率为93.48%(43/46),明显高于对照组的73.91%(34/46),差异有统计学意义(P<0.05)。随着治疗时间的延长,两组患者的HAMD-17评分、TESS评分均逐渐降低。治疗第2、4及8周末时,观察组患者HAMD-17评分较对照组同时间点明显降低,差异均有统计学意义(P<0.05);治疗第1、2、4及8周末时,两组患者TESS评分的差异均无统计学意义(P>0.05)。治疗后,两组患者外周血Th17细胞比例、Th17/Treg比值及血清IL-17水平较本组治疗前明显降低,外周血Treg细胞比例和血清IL-10水平则较本组治疗前明显升高,差异均有统计学意义(P<0.05);且与对照组治疗后相比,观察组患者同期外周血Th17细胞比例、Th17/Treg比值及血清IL-17水平明显降低,而外周血Treg细胞比例和血清IL-10水平明显升高,差异均有统计学意义(P<0.05)。结论:乌梅丸联合帕罗西汀治疗肝阳虚型抑郁症的整体疗效良好,且起效快,这可能与其有效维持患者外周血Th17/Treg细胞平衡、调控血清Th17/Treg相关细胞因子表达水平有关。OBJECTIVE:To probe into the clinical efficacy of Wumei pills combined with paroxetine in the treatment of depression of liver yang-deficiency type,and its effect on T helper cell-17(Th17)/T regulatory cell(Treg)balance and expression of related cytokines.METHODS:Totally 92 patients with depression of liver yang-deficiency type admitted into Guangzhou Hui'ai Hospital from May 2017 to Aug.2019 were selected and divided into observation group and control group via random number table,with 46 cases in each.The observation group was given Wumei pills combined with paroxetine,while the control group was treated with paroxetine alone,both groups were treated for 8 weeks.The clinical efficacy,scores of Hamilton Rating Scale(HAMD-17)before treatment and at 2,4,8 weeks after treatment,scores of treatment emergent symptom scale(TESS)at 1,2,4,8 weeks after treatment,interleukin-17(IL-17),interleukin-10(IL-10)and expression level of Th17/Treg in peripheral blood of both groups before and after treatment were observed.RESULTS:The total effective rate of observation group was 93.48%(43/46),which was significantly higher than that of the control group(73.91%,34/46),with statistically significant difference(P<0.05).With the extension of treatment time,scores of HAMD-17 and TESS of the two groups were gradually decreasing.At 2,4 and 8 weeks after treatment,HAMD-17 scores of observation group were significantly lower than those of the control group,with statistically significant differences(P<0.05);at 1,2,4 and 8 weeks after treatment,there were no statistical significance in differences in TESS scores between two groups(P>0.05).After treatment,the proportion of Th17,ratio of Th17/Treg and serum IL-17 level in peripheral blood of both groups were significantly lower than those of before treatment,while the proportion of Treg and serum IL-10 level had been significantly increased,with statistically significant differences(P<0.05);compared with the control group after treatment,the proportion of Th17,ratio of Th17/Treg and serum IL-1

关 键 词：乌梅丸 帕罗西汀 肝阳虚证 抑郁症 Th17/Treg失衡 白细胞介素17 白细胞介素10 

分 类 号：R932[医药卫生—生药学]