基于脑-肠轴途径探讨疏肝和胃汤对肝郁脾虚型抑郁症的治疗效果  

Exploring Therapeutic Effect of Shugan Hewei Decoction(疏肝和胃汤)on Patients with Depression Caused by Liver Depression and Spleen Deficiency Based on Brain-Gut Axis Approach

作　　者：谢珊珊 叶猛飞 何月敏 何国军 XIE Shanshan;YE Mengfei;HE Yuemin;HE Guojun(The Seventh People's Hospital of Shaoxing,Shaoxing 312000,Zhejiang,China)

机构地区：[1]绍兴市第七人民医院,浙江绍兴312000

出　　处：《中华中医药学刊》2023年第9期251-254,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省医药卫生科技计划项目(面上项目)(2020KY332)。

摘　　要：目的基于脑-肠轴途径探讨疏肝和胃汤对肝郁脾虚型抑郁症患者的治疗效果。方法选取2020年6月—2021年12月收治的肝郁脾虚型抑郁症患者102例,按照简单随机分组法分为对照组、观察组,每组51例。两组均给予艾司西酞普兰片治疗,观察组在此基础上予以疏肝和胃汤治疗,比较两组治疗前后汉密尔顿抑郁量表(hamilton depression scale,HAMD)、蒙哥马利抑郁评定量表(montgomery-Asberg depression rating Scale,MADRS)评分、5-羟色胺(5-HT)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、肠道菌群及临床疗效。结果治疗后,两组HAMD、MADRS评分均显著降低(P<0.05),且观察组HAMD、MADRS评分均低于对照组(P<0.05);治疗后,两组5-HT、BDNF水平均升高,且观察组5-HT、BDNF水平均高于对照组(P<0.05);治疗后,观察组肠杆菌低于对照组(P<0.05),肠球菌与对照组差异无统计学意义(P>0.05),乳酸杆菌、双歧杆菌和B/E比值均高于对照组(P<0.05);观察组有效率高于对照组(P<0.05)。结论疏肝和胃汤对肝郁脾虚型抑郁症患者疗效较好,可有效调节肠道菌群和神经递质,明显减轻症状。Objective To explore the therapeutic effect of Shugan Hewei Decoction(疏肝和胃汤)on patients with depression caused by liver depression and spleen deficiency based on brain-gut axis approach.Methods A total of 102 patients with liver depression and spleen deficiency depression treated in the hospital from June 2020 to December 2021 were selected and divided into control group and observation group according to simple random grouping method,with 51 cases in each group.Both groups were treated with escitalopram tablets,and the observation group was treated with Shugan Hewei Decoction on the basis of this.The Hamilton Depression Scale(HAMD),Montgomery Depression Rating Scale(MADRS)score,5-hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDNF),intestinal microflora and clinical efficacy of two groups were compared before and after treatment.Results After treatment,the HAMD and MADRS scores in both groups were significantly decreased(P<0.05),and the HAMD and MADRS scores in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of 5-HT and BDNF in both groups were increased,and the levels of 5-HT and BDNF in the observation group were higher than those in the control group(P<0.05).After treatment,the enterobacter of the observation group was lower than that of the control group(P<0.05),but there was no significant difference between two groups(P>0.05),and the ratio of Lactobacillus,bifidobacterium and B/E of the observation group was higher than that of the control group(P<0.05).The effec-tive rate of the observation group was higher than that of the control group(P<0.05).Conclusion Shugan Hewei Decoction has a good effect on patients with depression caused by liver depression and spleen deficiency,which can effectively regulate intestinal flora and neurotransmitters and significantly relieve symptoms.

关 键 词：舒肝和胃汤 艾司西酞普兰片 米氮平 焦虑症状 抑郁症 疗效 安全性 

分 类 号：R256.4[医药卫生—中医内科学]