摘要
目的探讨舒肝解郁胶囊联合米氮平对肝癌合并抑郁患者心理状态与癌因性疲乏的影响。方法选取2021年12月至2024年2月濮阳市人民医院肿瘤科收治的肝癌合并抑郁患者,采用随机数字表法分为联合组与米氮平组,两组完成临床观察各77例。联合组给予舒肝解郁胶囊联合米氮平治疗,米氮平组单用米氮平治疗,持续用药4周为1疗程。采用医院焦虑抑郁量表(HADS)与Piper疲乏修订量表(PFS-R)评估患者焦虑、抑郁状况与癌因性疲乏情况,比较两组治疗前后炎症因子与神经递质水平。结果治疗后联合组HADS抑郁、焦虑及总分[分别为(6.83±1.80)分、(6.29±2.87)分、(13.12±2.85)分]均低于米氮平组[分别为(10.84±1.93)分、(9.78±1.95)分、(20.62±3.03)分],差异有统计学意义(P<0.05);治疗后联合组PFS-R行为维度、情感维度、躯体维度、认知维度及总分[分别为(2.47±0.98)分、(2.58±0.88)分、(2.93±0.73)分、(2.84±0.94)分、(2.39±1.08)分]均低于米氮平组[分别为(5.36±1.83)分、(5.83±1.33)分、(5.27±1.65)分、(5.72±1.67)分、(5.93±1.54)分],差异有统计学意义(P<0.05);联合组治疗后超敏C反应蛋白、肿瘤坏死因子α(TNF-α)、白细胞介素1β[分别为(3.18±1.67)mg·L^(-1)、(12.71±5.93)pg·mL^(-1)、(8.13±4.90)pg·mL^(-1)]低于米氮平组[分别为(7.89±2.81)mg·L^(-1)、(16.48±6.78)pg·mL^(-1)、(14.88±5.34)pg·mL^(-1)],5-羟色胺、去甲肾上腺素、多巴胺水平[分别为(148.23±25.64)μg·L^(-1)、(43.13±9.83)ng·mL^(-1)、(4.64±1.56)μmol·L^(-1)]高于米氮平组[分别为(84.43±27.12)μg·L^(-1)、(27.16±12.45)ng·mL^(-1)、(2.88±1.49)μmol·L^(-1)],差异有统计学意义(P<0.05)。结论舒肝解郁胶囊联合米氮平治疗肝癌合并抑郁患者可有效改善心理症状,减轻癌因性疲乏,其作用机制可能与抑制炎症与调节神经递质有关。
Objective To investigate the effects of Shugan Jieyu capsule combined with mirtazapine on mental state and cancer-induced fatigue in patients with liver cancer and depression.Methods A total of 154 patients with liver cancer and depression admitted to Puyang People’s Hospital from December 2021 to February 2024 were divided into the combined group and mirtazapine group by using random number table method,with 77 in each group.The patients in the combined group were given Shugan Jieyu capsule combined with mirtazapine while those in the mirtazapine group only received mirtazapine.The treatment continued for 4 weeks in both groups.The hospital anxiety and depression scale(HADS)and Piper revised fatigue scale(PFS-R)were used to evaluate the patients’mental state and cancer-related fatigue symptoms.The levels of inflammatory factors and neurotransmitters before and after treatment were compared between the two groups.Results After treatment,the depression,anxiety and total score of HADS in the combined group((6.83±1.80)points,(6.29±2.87)points,(13.12±2.85)points)were lower than those in the mirtazapine group((10.84±1.93)points,(9.78±1.95)points,(20.62±3.03)points,respectively),and the differences were statistically significant(all P<0.05).The behavioral dimension,emotional dimension,physical dimension,cognitive dimension and total score of PFS-R scale in the combined group((2.47±0.98)points,(2.58±0.88)points,(2.93±0.73)points,(2.84±0.94)points,(2.39±1.08)points)were lower than those in the mirtazapine group((5.36±1.83)points,(5.83±1.33)points,(5.27±1.65)points,(5.72±1.67)points,(5.93±1.54)points,respectively),and the differences were statistically significant(all P<0.05).The levels of hypersensitive C-reactive protein,tumor necrosis factor-αand interleukin-1βwere(3.18±1.67)mg·L^(-1),(12.71±5.93)pg·mL^(-1),(8.13±4.90)pg·mL^(-1) in the combined group and they were lower than those of(7.89±2.81)mg·L^(-1),(16.48±6.78)pg·mL^(-1),(14.88±5.34)pg·mL^(-1) in the mirtazapine group.The levels of serotonin,norepinephrine and dopamine((148.23±25.64)μg·L^(-1),(43.13±9.83)ng·mL^(-1),(4.64±1.56)μmol·L^(-1))in the combined group were higher than those in the mirtazapine group((84.43±27.12)μg·L^(-1),(27.16±12.45)ng·mL^(-1),(2.88±1.49)μmol·L^(-1)),and the differences were statistically significant(all P<0.05).Conclusion Shugan Jieyu capsule combined with mirtazapine can effectively improve psychological symptoms and alleviate cancer-induced fatigue in patients with liver cancer and depression,and the mechanism of which may be related to inhibiting inflammation and regulating neurotransmitters.
作者
逯瑞娟
张攀
张科
Lu Ruijuan;Zhang Pan;Zhang Ke(Department of Psychological Counseling,Puyang People’s Hospital,Puyang 457000,China;Department of Nuclear Medicine,Puyang People’s Hospital,Puyang 457000,China;Department of Radiotherapy,Puyang People’s Hospital,Puyang 457000,China)
出处
《中国药物应用与监测》
2025年第5期787-791,共5页
Chinese Journal of Drug Application and Monitoring
关键词
舒肝解郁胶囊
米氮平
肝癌
抑郁
心理
癌因性疲乏
Shugan Jieyu capsule
Mirtazapine
Liver cancer
Depression
Psychology
Cancer-related fatigue
