摘要
目的探究不同剂量度洛西汀联合舒肝解郁胶囊治疗抑郁症的临床疗效和安全性。方法前瞻性选取2022年1月至2024年4月在北京市昌平区中西医结合医院接受治疗的抑郁症患者100例作为研究对象,按照随机数字表法将其分为低剂量组、高剂量组、低剂量联合组和高剂量联合组,每组各25例,分别接受40 mg/d度洛西汀、60 mg/d度洛西汀、40 mg/d度洛西汀和舒肝解郁胶囊、60 mg/d度洛西汀和舒肝解郁胶囊治疗,所有患者均治疗8周。比较4组患者临床治疗疗效,治疗前及治疗8周后汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)和匹兹堡睡眠质量指数(PSQI)、血清炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)]水平以及不良反应发生情况。结果治疗8周后,4组患者总有效率比较:高剂量联合组(96.00%)>低剂量联合组(80.00%)、高剂量组(76.00%)>低剂量组(48.00%),差异均有统计学意义(P<0.05),其中低剂量联合组与高剂量组总有效率比较,差异无统计学意义(P>0.05)。治疗8周后,4组HAMD评分和SDS评分均为高剂量联合组<高剂量组、低剂量联合组<低剂量组,差异均有统计学意义(P<0.05),其中低剂量联合组与高剂量组治疗8周后HAMD和SDS评分比较,差异均无统计学意义(P>0.05)。治疗8周后,PSQI评分高剂量联合组<低剂量联合组、高剂量组<低剂量组,差异均有统计学意义(P<0.05),其中低剂量联合组与高剂量组差异无统计学意义(P>0.05)。治疗8周后,血清CRP、IL-6和TNF-α水平比较:高剂量联合组<高剂量组、低剂量联合组<低剂量组,差异均有统计学意义(P<0.05),其中低剂量联合组与高剂量组比较,差异均无统计学意义(P>0.05)。治疗期间,4组不良反应总发生率、治疗伴发症状量表(TESS)评分比较,差异均无统计学意义(P>0.05)。结论在抑郁症治疗中,度洛西汀联合舒肝解郁胶囊可进一步改善临床疗效,其中高剂量度洛西汀联合舒肝解郁胶囊的疗效最为显著。相比单独使用度洛西汀,联合用药在相同剂量下可进一步提升疗效,且高剂量联合组在改善睡眠及抗炎作用方面表现最优。
Objective To explore the clinical efficacy and safety of different doses of duloxetine combined with Shugan Jieyu Capsules in the treatment of depressive disorder.Methods One hundred patients with depressive disorder treated at the Beijing Changping District Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to April 2024 were prospectively selected as the subjects and divided into four groups according to the random number table method:low-dose group,high-dose group,low-dose combination group,and high-dose combination group,with 25 patients in each group.They were receiveed treatment with 40 mg/day duloxetine,60 mg/day duloxetine,40 mg/day duloxetine and Shugan Jieyu Capsules,as well as 60 mg/day duloxetine and Shugan Jieyu Capsules.All patients were treated for 8 weeks.The clinical treatment efficacy of four groups of patients were compared.The Hamilton depression scale(HAMD),self-rating depression scale(SDS),Pittsburgh sleep quality index(PSQI),as well as serum C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)levels before treatment and after 8 weeks of treatment,and the incidence of adverse reastions of four groups patients were compared.Results After 8 weeks of treatment,the total effective rate of the four groups was compared:the high-dose combined group(96.00%)>the low-dose combined group(80.00%),the high-dose group(76.00%)>the low-dose group(48.00%),the differences were statistically significant(P<0.05);there was no statistically significant difference between the low-dose combined group and the high-dose group(P>0.05).After 8 weeks of treatment,the HAMD score and SDS score of the four groups was compared:the high-dose combined group<the high-dose group,the low-dose combined group<the low-dose group,the differences were statistically significant(P<0.05);there was no statistically significant difference between the low-dose combined group and the high-dose group(P>0.05).After 8 weeks of treatment,PSQI score of the four groups was compared:the high-dose combined group<the low-dose combined group,the high-dose group<the low-dose group,the differences were statistically significant(P<0.05),there was no statistically significant difference between the high-dose group and the low-dose combination group(P>0.05).After 8 weeks of treatment,the levels of serum CRP,IL-6 and TNF-αin the four groups were compared:the high-dose combined group<the high-dose group,the low-dose combined group<the low-dose group,the differences were statistically significant(P<0.05),there were no statistically significant differences between the low-dose combined group and the high-dose group(P>0.05).Conclusion In the treatment of depression,duloxetine combined with Shugan Jieyu Capsules can further improve the clinical efficacy,and the efficacy of high-dose duloxetine combined with Shugan Jieyu capsule is the most significant.Compared with duloxetine alone,combination therapy can further improve the efficacy at the same dose,and the high-dose combination group performs best in improving sleep and anti-inflammatory effects.
作者
汪迪
于滨
沈杨
WANG Di;YU Bin;SHEN Yang(Department of Psychiatry,Beijing Changping District Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 102208,China;Department of Clinical Medicine,Beijing Huilongguan Hospital,Beijing 100096,China)
出处
《临床和实验医学杂志》
2026年第2期184-188,共5页
Journal of Clinical and Experimental Medicine
基金
北京市中医药科技发展资金项目(编号:BJZYYB-2023-48)。
关键词
抑郁症
度洛西汀
舒肝解郁胶囊
睡眠质量
炎症因子
Depressive disorder
Duloxetine
Shugan Jieyu Capsules
Sleep quality
Inflammatory factors
