解郁丸联合米氮平对产后抑郁症患者神经内分泌功能的影响

Effects of Jieyu Pill Combined with Mirtazapine on Neuroendocrine Function in Patients with Postpartum Depression

    摘要
  • 摘要: 目的 观察解郁丸联合米氮平治疗产后抑郁症肝郁气滞证的临床疗效及对患者神经内分泌功能的影响。方法 采用随机对照法将我院78例产后抑郁症肝郁气滞证患者随机分为对照组和治疗组，对照组给予米氮平治疗，治疗组给予米氮平和解郁丸治疗，疗程8周。于治疗前、治疗2、4、8周后观察并比较2组患者的爱丁堡产后抑郁量表（EPDS）、不良反应症状量表（TESS）评价总体疗效，并于治疗前及治疗8周后测定患者血清中单胺类神经递质5-羟色胺(5-HT)、去甲肾上腺素(NE)、雌二醇(E2)及黄体酮（P）水平。结果 对照组和治疗组的有效率分别为79.48%和92.31%（P<0.01）。治疗后2、4、8周与治疗前EPDS评分比较2组均明显降低（P<0.05~0.01），从治疗第2周末期起，治疗组的EPDS的评分与对照组的EPDS的评分比较明显下降（P<0.05~0.01）。治疗后2组患者血清中的5-HT、NE和E2水平较治疗前明显升高，P水平较治疗前有明显降低（P<0.01），治疗组优于对照组（P<0.05~0.01）。对照组的不良反应总数9例（23.01%），TESS值为（6.41±0.57），治疗组的不良反应总例数4例（10.25%），TESS值为（3.10±0.29），2组TESS值比较差异有显著性意义（P＜0.05）。结论 解郁丸联合米氮平治疗产后抑郁症肝郁气滞证的临床疗效佳，且不良反应少，并能有效地调整抑郁症患者5-HT、NE、E2和P的水平，从而改善患者临床症状。

     

    Abstract: OBJECTIVE To observe the clinical effect of Jieyu pill combined with mirtazapine in the treatment of patients with postpartum depression， and its impact on patients' neuroendocrine function. METHODS 78 patients with postpartum depression admitted in our hospital were randomly divided into the control group and the treatment group with random control method. The control group was treated with mirtazapine， and the treatment group was treated with mirtazapine combined with Jieyu pill， both groups were treated for eight weeks. Edinburgh postpartum depression scale (EPDS)， Treatment Emergent Symptom Scale (TESS) and the overall effects of two groups were observed and compared at pre-treatment， and 2， 4， 8 weeks after treatment. Levels of monoamine neurotransmitter 5-hydroxytryptamine(5-HT)， norepinephrine (NE)， estradiol (E2) and progesterone (P) in patients' serum were measured at pre-treatment and 8 weeks after treatment. RESULTS The effective percentages of the control group and the treatment group were 79.48% and 92.31%， respectively (P<0.01). EPDS scores in two groups of 2， 4， 8 weeks after treatment were significantly decreased compared those of the pre-treatment. From the end of the 2nd week treatment， EPDS score in the treatment group was significantly decreased than that in the control group (P<0.01). Levels of 5-HT， NE and E2 in patients' serum of two groups were increased significantly after treatment than those of the pre-treatment， and P level was decreased significantly than that of the pre-treatment (P<0.01). There were total 9 cases (23.01%) occurred adverse reactions in the control group， and the TESS value was （6.41±0.57）. There were total 4 cases (10.25%) occurred adverse reactions in the treatment group， and the TESS value was （3.10±0.29）. The TESS values in both groups were statistically significant (P<0.05). CONCLUSION Jieyu pill combined with mirtazapine has the satisfactory clinical effect for the treatment of postpartum depression with few adverse reactions. And it can effectively regulate the 5-HT， NE， E2 and P levels of depression patients， and proceed to improve the clinical symptoms of patients.

     

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