逍遥二仙汤加减治疗围绝经期综合征情绪障碍的临床疗效  

Modified Xiaoyao Erxian Decoction in Treatment of Mood Disorders in Perimenopausal Syndrome

作　　者：周雨禾 刘婷[3] 马宏博 ZHOU Yu-he;LIU Ting;MA Hong-bo(Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;School of Chinese Medicine,Shandong University of Traditional Chinese Medicine(TCM),Jinan 250355,China;The Second Affiliated Hospital of Shandong University of TCM,Jinan 250001,China)

机构地区：[1]山东第一医科大学附属省立医院,济南250021 [2]山东中医药大学中医学院,济南250355 [3]山东中医药大学第二附属医院,济南250001

出　　处：《中国实验方剂学杂志》2021年第21期144-149,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家中医药管理局第四批全国中医临床优秀人才研修项目(国中医药人教发[2017]24号);山东省名中医药专家传承工作室建设项目(鲁卫函[2019]92号)。

摘　　要：目的:观察逍遥二仙汤加减治疗围绝经期综合征情绪障碍(肾虚肝郁证)的临床疗效及对单胺类神经递质和脑源性神经营养因子(BDNF)的影响。方法:将108例患者按随机数字表法分为对照组和观察组各54例。对照组口服舒肝解郁胶囊,2粒/次,2次/d;观察组口服逍遥二仙汤加减,1剂/d。两组疗程均为12周。进行治疗前后汉密尔顿焦虑量表(HAMA),汉密尔顿抑郁量表-17(HAMD-17),改良Kupperman指数(KI),匹兹堡睡眠质量指数(PSQI),绝经期生存质量量表(MENQOL)和肾虚肝郁证评分;检测治疗前后雌二醇(E_(2)),卵泡生成素(FSH),黄体生成素(LH),BDNF,5-羟色胺(5-HT),去甲肾上腺素(NE)和多巴胺(DA)水平;进行安全性评价。结果:观察组HAMA和HAMD-17评分均低于对照组(P<0.01);观察组KI,肾虚肝郁证,PSQI和MENQOL评分均低于对照组(P<0.01);观察组5-HT,E_(2),DA,NE和BDNF水平均高于对照组(P<0.01);观察组临床疗效高于对照组(Z=2.184,P<0.05);两组患者观察期间均没有发现与服用中药相关不良反应。结论:采用逍遥二仙汤加减治疗围绝经期情绪障碍(肾虚肝郁证)患者,可有效减轻情绪障碍及相关症状,并能调节单胺类神经递质、神经营养因子及雌激素,临床疗效显著,且使用安全。Objective:To observe the clinical efficacy of modified Xiaoyao Erxian decoction in the treatment of mood disorders among perimenopausal syndrome due to kidney deficiency and liver depression and its effects on monoamine neurotransmitters and brain-derived neurotrophic factor(BDNF).Method:According to the random number table,108 patients were divided into a control group(54 cases)and an observation group(54 cases).Control group were treated with Shugan Jieyu capsule orally,two capsules per time,two times per day,while those in the observation group received the modified Xiaoyao Erxian decoction,one bag per day,for 12 consecutive weeks.Before and after treatment,the Hamilton Anxiety Scale(HAMA),17-item Hamilton Depression Rating Scale(HAMD-17),modified Kupperman Index(KI),Pittsburgh Sleep Quality Index(PSQI),Menopause-specific Quality of Life(MENQOL)and kidney deficiency and liver depression syndrome scores were calculated.The levels of estradiol(E_(2)),follicle-stimulating hormone(FSH),luteinizing hormone(LH),BDNF,5-hydroxytryptamine(5-HT),norepinephrine(NE),and dopamine(DA)were detected,followed by safety evaluation.Result:The HAMA,HAMD-17,KI,kidney deficiency and liver depression syndrome,PSQI,and MENQOL scores of the observation group were lower than those of the control group(P<0.01),whereas the 5-HT,E_(2),DA,NE,and BDNF levels in the observation group were higher(P<0.01).The clinical efficacy of the observation group was superior to that in the control group(Z=2.184,P<0.05).No adverse reactions occurred after the oral administration of Chinese medicinal preparations.Conclusion:The modified Xiaoyao Erxian decoction effectively alleviates the mood disorders and other related symptoms of perimenopausal syndrome due to kidney deficiency and liver depression by regulating the monoamine neurotransmitters,BDNF,and E_(2),without inducing obvious side effects.

关 键 词：围绝经期综合征 肾虚肝郁证 逍遥散 二仙汤 二至丸 逍遥二仙汤 单胺类神经递质 脑源性神经营养因子 

分 类 号：R289[医药卫生—方剂学] R271[医药卫生—中药学]