疏肝健脾方联合氟哌噻吨美利曲辛片治疗乳腺癌后伴抑郁患者的疗效观察  

Therapeutic Effect of Shugan Jianpi Formula Combined with Flupentixol-Melitracen Tablets on Depression after Breast Cancer

作　　者：郑美媛 梁军霞 寇宇 唐贺利 ZHENG Mei-yuan;LIANG Jun-xia;KOU Yu;TANG He-li(Department of Oncology,Tangshan Traditional Chinese Medicine Hospital,Tangshan Hebei 063000;Department of Encephalopathy,Tangshan Traditional Chinese Medicine Hospital,Tangshan Hebei 063000;Department of Rehabilitation,Tangshan Traditional Chinese Medicine Hospital,Tangshan Hebei 063000)

机构地区：[1]唐山市中医医院肿瘤科,河北唐山063000 [2]唐山市中医医院脑病科,河北唐山063000 [3]唐山市中医医院康复科,河北唐山063000

出　　处：《世界中西医结合杂志》2024年第8期1614-1618,1624,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2021399)。

摘　　要：目的探讨疏肝健脾方联合氟哌噻吨美利曲辛片治疗乳腺癌后伴抑郁患者的临床疗效。方法选取2020年6月—2022年6月期间唐山市中医医院收治的乳腺癌后伴抑郁患者80例,按随机数字表法分为对照组和观察组,每组各40例。对照组予氟哌噻吨美利曲辛片治疗,观察组在对照组基础上联合疏肝健脾方治疗,均连续治疗8周。观察比较两组患者临床疗效、不良反应发生率、抑郁情绪发生率、睡眠障碍发生率,治疗前后中医证候积分、汉密尔顿抑郁量表(HAMD)评分、焦虑情绪评分(SAS)、睡眠质量评分(PSQI)、神经递质指标[5-羟色胺(5-hydroxytryptamine,5-HT)、去甲肾上腺素(Norepinephrine,NE)、多巴胺(Dopamine,DA)]改善情况。结果治疗后两组患者情绪低落、善忧多疑、思虑过度、神疲乏力评分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组情绪低落、善忧多疑、思虑过度、神疲乏力评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者HAMD、SAS、PSQI评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组HAMD、SAS、PSQI评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者神经递质5-HT、NE、DA水平均较治疗前升高,差异有统计学意义(P<0.05);且观察组神经递质5-HT、NE、DA水平均明显高于对照组,差异有统计学意义(P<0.05)。治疗后观察组总有效率92.50%(37/40)明显高于对照组75.00%(30/40),差异有统计学意义(P<0.05)。治疗后对照组抑郁情绪发生率10.00%(4/40),睡眠障碍发生率15.00%(6/40);观察组患者抑郁情绪发生率2.50%(1/40),睡眠障碍发生率5.00%(2/40);两组患者抑郁情绪、睡眠障碍发生率比较,差异无统计学意义(P>0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论疏肝健脾方联合氟哌噻吨美利曲辛片能够促进乳腺癌后伴抑郁(肝郁脾虚证)患者神经�Objective To observe the therapeutic effect of Shugan Jianpi Formula combined with flupentixol-melitracen tablets on depression after breast cancer.Methods Eighty patients with depression after breast cancer treated in the Tangshan Traditional Chinese Medicine Hospital from June 2020 to June 2022 were selected and assigned with the random number table method into a control group and an observation group,with 40 patients in each group.The control group was treated with flupentixol-melitracen tablets,while the observation group was treated with Shugan Jianpi Formula on the basis of the therapy in the control group.Both groups were treated for 8 weeks.The therapeutic effect and the incidence of adverse reactions,depression emotion,and sleep disorders were compared between the two groups.The traditional Chinese medicine(TCM)symptom scores,Hamilton Depression Scale(HAMD)score,Self-Rating Anxiety Scale(SAS)score,Pittsburgh Sleep Quality Index(PSQI),and levels of neurotransmitters[5-hydroxytryptamine(5-HT),norepinephrine(NE),and dopamine(DA)]were measured before and after treatment.Results After treatment,the scores of low mood,worry and suspicion,overthinking,fatigue,HAMD,SAS,and PSQI in both groups declined(P<0.05),and the observation group had lower scores than the control group(P<0.05).After treatment,the levels of 5-HT,NE,and DA in both groups rose(P<0.05),and the observation group had higher levels of 5-HT,NE,and DA than the control group(P<0.05).The total response rate in the observation group was 92.50%(37/40),which was higher than that(75.00%,30/40)in the control group(P<0.05).The incidence of depression emotion and sleep disorders in the control group was 10.00%(4/40)and 15.00%(6/40),respectively,which had no significant difference compared with that[2.50%(1/40)and 5.00%(2/40)]in the observation group(P>0.05).The incidence of adverse reactions showed no significant difference between the two groups during the treatment period(P>0.05).Conclusion Shugan Jianpi Formula combined with flupentixol-melitracen tablets

关 键 词：乳腺癌 抑郁 疏肝健脾方 氟哌噻吨美利曲辛片 肝郁脾虚证 神经递质 

分 类 号：R737.9[医药卫生—肿瘤] R749.41[医药卫生—临床医学]