益肾调气法治疗肾虚肝郁型抑郁障碍远期复发率的多中心前瞻性队列研究  

Long-term Recurrence Rate of Depressive Disorder with Kidney Deficiency and Liver Depression Syndrome by Kidney-tonifying and Qi-regulating Therapy:A Multi-centered,Prospective Cohort Study

作　　者：叶橙 孙文军 唐启盛 黄世敬[3] 王娣[4] 郑军然 李小黎 尹洪娜[6] 刘向哲[7] 李乐军 王志强[9] 徐向青[10] 杨文明[11] 林安基[12] 马良[13] 曲淼 YE Cheng;SUN Wenjun;TANG Qisheng;HUANG Shijing;WANG Di;ZHENG Junran;LI Xiaoli;YIN Hongna;LIU Xiangzhe;LI Lejun;WANG Zhiqiang;XU Xiangqing;YANG Wenming;LIN Anji;MA Liang;QU Miao(Xuanwu Hospital of Capital Medical University,Beijing 100053,China;The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;Guang′anmen Hospital of China Academy of Chinese Medical Sciences,Beijing 100053,China;Beijing Anding Hospital of Capital Medical University,Beijing 100088,China;Huilongguan Hospital of Beijing 100096,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Changchun 130021,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;Suzhou Hospital,Nanjing University of Chinese Medicine,Suzhou 215003,China;Beijing Chuiyangliu Hospital,Tsinghua University,Beijing 100022,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji′nan 250011,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Xiamen Hospital,Beijing University of Chinese Medicine,Xiamen 361001,China;Beijing Chaoyang District Third Hospital,Beijing 100025,China)

机构地区：[1]首都医科大学宣武医院,北京100053 [2]北京中医药大学第三附属医院,北京100029 [3]中国中医科学院广安门医院,北京100053 [4]首都医科大学附属北京安定医院,北京100088 [5]北京回龙观医院,北京100096 [6]黑龙江中医药大学附属第二医院,长春130021 [7]河南中医药大学第一附属医院,郑州450000 [8]南京中医院大学附属苏州医院,苏州215003 [9]清华大学附属北京市垂杨柳医院,北京100022 [10]山东中医药大学附属医院,济南250011 [11]安徽中医药大学第一附属医院,合肥230031 [12]北京中医药大学厦门医院,厦门361001 [13]北京市朝阳区第三医院,北京100025

出　　处：《世界中医药》2024年第15期2308-2313,共6页World Chinese Medicine

基　　金：国家重点研发计划项目(2020YFC2003100,2020YFC2003103);国家中医药行业专项(201507001-12)。

摘　　要：目的:评价益肾调气法对肾虚肝郁型抑郁障碍2年复发率的影响。方法:选取2017年1月至2018年4月在全国13个分中心招募肾虚肝郁型抑郁障碍患者,按照接受的治疗方案自然形成中医组、中西医组和西医组,比较3组的复发率。并根据干预的时间,将中医组和中西医组分为低、中、高3个暴露水平,比较不同水平的复发率,评价益肾调气法降低肾虚肝郁型抑郁障碍的远期复发率的效果。结果:共纳入肾虚肝郁型抑郁障碍1314例,其中中医组385例,西医组453例,中西医组476例。中医组、西医组、中西医组的两年复发率分别是23.61%,34.97%、18.14%。中医组比西医组使复发风险降低29.2%(P<0.05),中西医组比西医组使复发风险降低45.5%(P<0.001)。中医组以低中药水平暴露时间(TCM-ET)为参照,高TCM-ET较于低TCM-ET复发风险降低81.4%(P<0.01);中西医组以低TCM-ET为参照,中TCM-ET比低TCM-ET复发风险降低46.9%(P<0.05),高TCM-ET比低TCM-ET复发风险降低65.3%(P<0.01)。结论:益肾调气法治疗肾虚肝郁型抑郁障碍能够降低远期复发率,且中医药干预的暴露水平与复发率之间具有密切的关系,较长的暴露水平显著降低了患者的复发率。Objective:To evaluate the effect of kidney-tonifying and qi-regulating therapy on the 2-year recurrence rate of depressive disorder with kidney deficiency and liver depression syndrome.Methods:Patients with depressive disorder characterized by kidney deficiency and liver depression syndrome were recruited from 13 sub-centers in China between January 2017 and April 2018.According to the treatment they received,patients were naturally divided into a traditional Chinese medicine(TCM)group,an integrated TCM and Western medicine group,and a Western Medicine group.The recurrence rates of the three groups were compared.Additionally,based on the duration of intervention,the TCM and integrated groups were divided into low,medium,and high exposure levels,and the recurrence rates at different levels were compared to evaluate the long-term effect of the kidney-tonifying and qi-regulating therapy in reducing the recurrence rate of depressive disorder with kidney deficiency and liver depression syndrome.Results:A total of 1314 patients with depressive disorder characterized by kidney deficiency and liver depression syndrome were included,with 385 in the TCM group,453 in the Western medicine group,and 476 in the integrated group.The 2-year recurrence rates for the TCM,Western medicine,and integrated groups were 23.61%,34.97%,and 18.14%,respectively.The TCM group had a 29.2%lower risk of recurrence compared to the Western medicine group(P<0.05),and the integrated group had a 45.5%lower risk of recurrence compared to the Western medicine group(P<0.001).Using low TCM exposure time(TCM-ET)as a reference in the TCM group,high TCM-ET significantly reduced the risk of recurrence by 81.4%(P<0.01).In the integrated group,compared to low TCM-ET,medium TCM-ET reduced the risk of recurrence by 46.9%(P<0.05),and high TCM-ET reduced the risk by 65.3%(P<0.01).Conclusion:Kidney-tonifying and qi-regulating therapy can reduce the long-term recurrence rate of depressive disorder with kidney deficiency and liver depression syndrome.There is a clos

关 键 词：复发率 益肾调气法 抑郁障碍 颐脑解郁方 前瞻性 队列研究 多中心 多因素回归分析 

分 类 号：R289[医药卫生—方剂学]