解郁宁神汤联合草酸艾司西酞普兰对抑郁性神经症肝气郁结证患者血清DA、5-HT、NE及TNF-α的影响  

Effect of Jieyu Ningshen Decoction(解郁宁神汤)Combined with Escitalopram Oxalate on Serum DA,5-HT,NE and TNF-αin Patients with Depressive Neurosis of Liver Qi Stagnation Syndrome

作　　者：谭庆晶[1] 龙丽灯 陈卓 刘永辉[1] 杨俊威 梁慧[1] TAN Qingjing;LONG Lideng;CHEN Zhuo;LIU Yonghui;YANG Junwei;LIANG Hui(The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning Guangxi 530023,China;Graduate School of Guangxi University of Chinese Medicine,Nanning Guangxi 530200,China;Hubei University of Traditional Chinese Medicine,Wuhan Hubei 430065,China)

机构地区：[1]广西中医药大学第一附属医院,广西南宁530023 [2]广西中医药大学研究生院,广西南宁530200 [3]湖北中医药大学,湖北武汉430065

出　　处：《中医药导报》2023年第1期81-85,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：广西自然科学基金面上项目(2020GZNSFAA297161);广西中医药大学自然科学基金面上项目(2019MS025);广西壮族自治区中医药管理局自筹经费科研课题(GXZYZ20210018)。

摘　　要：目的:研究解郁宁神汤联合草酸艾司西酞普兰治疗抑郁性神经症肝气郁结证患者的临床疗效及对其血清多巴胺(DA)、5-羟色胺(5-HT)、去甲肾上腺素(NE)及肿瘤坏死因子-α(TNF-α)的影响,同时分析血清DA、5-HT、NE及TNF-α与汉密尔顿抑郁量表(HAMD)评分的关系,探讨解郁宁神汤抗抑郁可能的作用机制。方法:将60例抑郁性神经症肝气郁结证患者随机分为治疗组和对照组各30例,对照组患者予草酸艾司西酞普兰治疗,治疗组患者予解郁宁神汤联合草酸艾司西酞普兰治疗,治疗时间均为6周。分别记录患者治疗前后HAMD评分、不良反应发生情况,检测血清DA、5-HT、NE及TNF-α水平,并评价临床疗效。结果:治疗组总有效率为86.67%(26/30),对照组总有效率为60.00%(18/30),治疗组疗效优于对照组,差异有统计学意义(P<0.05)。治疗组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后HAMD评分均较治疗前降低(P<0.05),且治疗组患者治疗后HAMD评分低于对照组(P<0.05)。两组患者治疗后血清DA、5-HT、NE水平均较治疗前升高,且治疗后治疗组患者血清DA、5-HT、NE水平均高于对照组(P<0.05)。两组患者治疗后血清TNF-α均较治疗前降低(P<0.05),且治疗组患者治疗后血清TNF-α低于对照组(P<0.05)。Spearman相关分析显示,血清5-HT水平与HAMD评分呈明显负相关(r=-0.958,P<0.05)。结论:解郁宁神汤联合草酸艾司西酞普兰治疗抑郁性神经症肝气郁结证患者的临床疗效优于单纯草酸艾司西酞普兰治疗,可减少不良反应发生率,同时解郁宁神汤联合草酸艾司西酞普兰可升高血清DA、5-HT、NE水平,降低血清TNF-α水平。Objective:To study the clinical efficacy of Jieyu Ningshen decoction combined with escitalopram oxalate in the treatment of depressive neurosis patients with liver Qi stagnation syndrome and its effect on serum dopamine(DA),5-hydroxytryptamine(5-HT),norepinephrine(NE)and tumor necrosis factor-α(TNF-α),to analyze the relationship between serum DA,5-HT,NE,TNF-αand Hamilton Depression Scale(HAMD)score in order to explore the possible action mechanism of Jieyu Ningshen Decoction on depression.Methods:Totally 60 cases of depressive neurosis with liver Qi stagnation syndrome were randomly divided into treatment group(n=30)and control group(n=30).Patients were treated with escitalopram oxalate in control group,while Jieyu Ningshen decoction combined with escitalopram oxalate in treatment group.Patients were treated for 6 weeks in two groups.The HAMD score and adverse reactions were recorded before and after treatment.The levels of serum DA,5-HT,NE and TNF-αwere detected,and the clinical efficacy was evaluated.Results:The total effective rate was 86.67%(26/30)in treatment group and 60.00%(18/30)in control group.The treatment group showed better efficacy than control group and the difference was statistically significant(P<0.05).The treatment group showed lower incidence of adverse reactions than control group,with statistically significant difference(P<0.05).The HAMD scores decreased in two groups after treatment(P<0.05),and the treatment group showed lower HAMD score than control group after treatment(P<0.05).The levels of serum DA,5-HT and NE increased in the two groups after treatment(P<0.05),and the treatment group showed higher levels of serum DA,5-HT and NE than control group after treatment(P<0.05).The serum TNF-αdecreased in the two groups after treatment(P<0.05),and the treatment group showed lower serum TNF-αthan control group after treatment(P<0.05).Spearman correlation analysis showed that serum 5-HT level was negatively correlated with HAMD score(r=-0.958,P<0.05).Conclusion:The clinical efficacy of Jie

关 键 词：抑郁性神经症 肝气郁结证 解郁宁神汤 草酸艾司西酞普兰 多巴胺 5-羟色胺 去甲肾上腺素 肿瘤坏死因子-α 

分 类 号：R256.49[医药卫生—中医内科学]