鹿角龟芍汤联合盐酸帕罗西汀治疗围绝经期抑郁症的效果及对神经递质、生殖内分泌激素的影响  

Effect of Lujiao Guishao Decoction Combined with Paroxetine Hydrochloride in the Treatment of Perimenopausal Depression and Its Effects on Neurotransmitters and Reproductive Endocrine Hormones

作　　者：王春华 朱人杰 董君伟 WANG Chun-hua;ZHU Ren-jie;DONG Jun-wei(Population Monitoring and Family Development Division,Health Commission of Chengde City,Chengde,Hebei 067000,China;Department of Emergency,Central Hospital of Chengde City,Chengde,Hebei 067000,China;Department of Gynecology and Obstetrics,Chengde Hospital of Traditional Chinese Medicine,Chengde,Hebei 067000,China)

机构地区：[1]承德市卫生健康委员会人口监测与家庭发展科,河北承德067000 [2]承德市中心医院急诊科,河北承德067000 [3]承德市中医院妇产科,河北承德067000

出　　处：《临床误诊误治》2022年第11期41-46,共6页Clinical Misdiagnosis & Mistherapy

基　　金：河北省中医药学会科学技术项目(20162079)。

摘　　要：目的探讨鹿角龟芍汤联合盐酸帕罗西汀治疗围绝经期抑郁症的效果及对神经递质、生殖内分泌激素的影响。方法选取2020年1月—2022年1月收治的围绝经期抑郁症104例,按照治疗方法不同将其分为观察组和对照组2组各52例。观察组给予鹿角龟芍汤联合盐酸帕罗西汀治疗,对照组给予盐酸帕罗西汀治疗。比较2组治疗8周后临床效果及治疗前、治疗8周后抑郁症状[汉密尔顿抑郁量表-17(HADM-17)和抑郁自评量表(SDS)评分]、围绝经期症状[绝经评定量表(MRS)和改良围绝经期Kupperman指数(KI)评分]、神经递质[去甲肾上腺素(NE)、5-羟色胺(5-HT)、多巴胺(DA)]、生殖内分泌激素[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))和睾酮(T)],以及治疗期间不良反应发生情况。结果治疗8周后,总有效率观察组高于对照组;HADM-17、SDS、MRS、改良围绝经期KI评分及血清FSH、LH、T水平2组均较治疗前下降,且观察组低于对照组;血清NE、5-HT、DA和E_(2)水平2组均较治疗前升高,且观察组高于对照组(P<0.05)。治疗期间,2组不良反应发生率比较差异无统计学意义(P>0.05)。结论鹿角龟芍汤联合盐酸帕罗西汀治疗围绝经期抑郁症效果显著,可明显改善抑郁及围绝经期症状,调节神经递质及生殖内分泌激素,且安全性较高。Objective To investigate the effect of Lujiao Guishao decoction combined with Paroxetine Hydrochloride in the treatment of perimenopausal depression and its effects on neurotransmitters and reproductive endocrine hormones.Methods A total of 104 female patients with perimenopausal depression who were admitted to our hospital from January 2020 to January 2022 were selected and divided into the observation group(n=52)and the control group(n=52)according to different treatment plans.The control group was treated with Paroxetine Hydrochloride,and the observation group was treated with Lujiao Guishao decoction combined with Paroxetine Hydrochloride for a total of 8 weeks.The clinical effect at 8 weeks after treatment,depressive symptoms[Hamilton Depression Scale-17(HADM-17)score,Self-rating Depression Scale(SDS)score],perimenopausal symptoms[Menopause Rating Scale(MRS)score,Modified Kupperman Menopausal Index(KI)score],neurotransmitters[norepinephrine(NE),serotonin(5-HT),dopamine(DA)],reproductive endocrine hormones[follicle stimulating hormone(FSH),luteinizing hormone(LH),estrogen Diol(E_(2)),testosterone(T)]levels before and at 8 weeks after treatment and adverse reactions during treatment were compared between the two groups.Results At 8 weeks after treatment,the total effective rate was higher in the observation group than in the control group;the HADM-17,SDS,MRS and modified KI scores as well as serum FSH,LH and T levels of the two groups were all lower than those before treatment,and lower in the observation group than in the control group;the serum levels of NE,5-HT,DA and E_(2) were higher than those before treatment,and higher in the observation group than in the control group(P<0.05).No significant difference was found in the incidence of adverse reactions during treatment between the two groups(P>0.05).Conclusion Lujiao Guishao decoction combined with Paroxetine Hydrochloride in the treatment of perimenopausal depression is effective,which can significantly improve perimenopausal symptoms and depression symp

关 键 词：抑郁症 围绝经期 鹿角龟芍汤 盐酸帕罗西汀 汉密尔顿抑郁量表-17 绝经评定量表 去甲肾上腺素 卵泡刺激素 

分 类 号：R749.42[医药卫生—神经病学与精神病学]