摘要
目的探讨小补肝汤加减对肝肾阴虚型抑郁状态患者中医证候、睡眠质量及抑郁程度的影响。方法回顾性分析2022年3月至2025年3月首都医科大学附属北京潞河医院收治的134例肝肾阴虚型抑郁状态患者的临床资料。按照治疗方法不同将患者分为对照组(n=67)和治疗组(n=67)。对照组采用氟哌噻吨美利曲辛片治疗,治疗组采用加用小补肝汤加减治疗,均治疗8周。观察两组治疗前、治疗8周后的中医证候、睡眠质量评分[匹兹堡睡眠质量指数(PSQI)]、神经内分泌指标[皮质醇、促肾上腺皮质激素(ACTH)、醛固酮]、抑郁程度[汉密尔顿抑郁量表(HAMD-17)]变化和不良反应发生情况。结果治疗8周后,两组患者的情绪不宁、目干畏光、腰酸肢软、急躁易怒各症状积分较治疗前均下降,且治疗组的以上各症状积分均低于对照组,差异均有统计学意义(P<0.05)。治疗8周后,两组患者的主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍和日间功能障碍PSQI各维度评分较治疗前均下降,且治疗组以上PSQI各维度评分均低于对照组,差异均有统计学意义(P<0.05)。治疗8周后,两组患者的皮质醇、ACTH、醛固酮水平较治疗前均下降,且治疗组的皮质醇、ACTH、醛固酮水平均低于对照组,差异均有统计学意义(P<0.05)。治疗8周后,两组患者的情绪症状、认知与行为症状、生理症状、绝望感与偏执症状HAMD-17各维度评分较治疗前均下降,且治疗组以上HAMD-17各维度评分均低于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论小补肝汤加减能有效改善肝肾阴虚型抑郁状态患者的中医证候,提升睡眠质量,调节下丘脑-垂体-肾上腺皮质轴,缓解疾病严重程度,且具有安全性,值得临床推广应用。
Objective To explore the influence of modified Xiaobugan Decoction on TCM syndromes,sleep quality and depression degree in patients with liver-kidney yin deficiency type of depressive state.Methods The clinical data of 134 patients with depression of liver-kidney yin deficiency type admitted to Beijing Luhe Hospital,Capital Medical University from March 2022 to March 2025 were retrospectively analyzed.According to different treatment methods,the patients were divided into the control group(n=67)and the treatment group(n=67).The control group was treated with flupentixol and melitracen tablets,whereas the treatment group was added with modified Xiaobugan Decoction,and both groups were treated for 8 weeks.TCM syndromes,sleep quality scores[Pittsburgh sleep quality index(PSQI)],neuroendocrine indicators[cortisol,adrenocorticotropic hormone(ACTH),aldosterone],depression degree[Hamilton depression rating scale(HAMD-17)]before treatment and after 8 weeks of treatment and adverse reactions of both groups were observed.Results After 8 weeks of treatment,the symptom scores of restless mood,dry eyes and photophobia,soreness and weakness of waist,irritability in the two groups were lower than those before treatment,and the above symptom scores in the treatment group were lower than those in the control group,the differences were statistically significant(P<0.05).After 8 weeks of treatment,the PSQI scores of subjective sleep quality,sleep time,sleep time,sleep efficiency,sleep disorder and daytime dysfunction in the two groups were lower than those before treatment,and the PSQI scores in the treatment group were lower than those in the control group,the differences were statistically significant(P<0.05).After 8 weeks of treatment,the levels of cortisol,ACTH and aldosterone in the two groups were lower than those before treatment,and the levels of cortisol,ACTH and aldosterone in the treatment group were lower than those in the control group,the differences were statistically significant(P<0.05).After 8 weeks of treatment,the HAMD-17 scores of emotional symptoms,cognitive and behavioral symptoms,physiological symptoms,despair and paranoid symptoms in the two groups were lower than those before treatment,and the HAMD-17 scores in the treatment group were lower than those in the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Modified Xiaobugan Decoction can effectively improve the TCM syndromes in patients with liver-kidney yin deficiency type of depressive state,enhance the sleep quality,regulate the hypothalamic-pituitary-adrenal axis,and alleviate the disease severity,with safety.
作者
白洁
李敏
王培
王正
杨春霞
徐静
BAI Jie;LI Min;WANG Pei(Traditional Chinese Medicine Center,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China)
出处
《临床和实验医学杂志》
2026年第5期468-473,共6页
Journal of Clinical and Experimental Medicine
基金
首都卫生发展科研专项项目(编号:2022-2-7082)。
关键词
抑郁状态
小补肝汤加减
中医证候
睡眠质量
Depressive state
Xiaobugan Decoction
TCM syndromes
Sleep quality
