疏肝与胃方治疗肿瘤相关性抑郁临床研究.docVIP

疏肝与胃方治疗肿瘤相关性抑郁临床研究 　　摘要：目的 ?^察疏肝和胃方治疗肿瘤相关性抑郁的临床疗效。方法 将92例患者随机分为对照组和治疗组各46例。2组患者均已完成肿瘤针对性治疗（如放疗、化疗），病情处于稳定阶段。对照组予盐酸氟西汀分散片，每次20 mg，每日1次，口服；治疗组予疏肝和胃方，每日1剂，每日2次，口服。均治疗6周。观察2组治疗前后汉密顿抑郁量表（HAMD）评分、卡氏评分（KPS），检测脑内神经递质去甲肾上腺素（NE）、5-羟色胺（5-HT）水平，血清白细胞介素-6（IL-6）及肿瘤坏死因子（TNF）-α含量，并进行安全监测。结果 与本组治疗前比较，2组治疗后HAMD评分明显降低（P0.01）；治疗后治疗组HAMD评分低于对照组（P0.01）。治疗组治疗后KPS较治疗前升高，且优于对照组（P0.05）。与本组治疗前比较，2组治疗后脑内NE、5-HT水平升高，IL-6、TNF-α水平降低（P0.05）。治疗后治疗组脑内NE、5-HT水平高于对照组，IL-6、TNF-α水平低于对照组（P0.05，P0.01）。治疗组未见不良事件，对照组轻度恶心5例、肝功能异常6例。结论 疏肝和胃方可提高肿瘤相关性抑郁患者脑内NE、5-HT水平，降低细胞因子水平，改善肿瘤患者抑郁状态。 　　关键词：恶性肿瘤；疏肝和胃方；抑郁；神经递质 　　DOI：10.3969/j.issn.1005-5304.2017.11.006 　　中图分类号：R273；R277.794 文献标识码：A 文章编号：1005-5304（2017）11-0022-04 　　Abstract： Objective To observe the clinical efficacy of Shugan Hewei Formula for cancer-related depression. Methods Totally 92 cancer-related depression patients were randomly divided into two groups， with 46 patients in each group. All patients already finished the treatment such as radiotherapy and chemotherapy， and were in stable stage. The Fluoxetine Hydrochloride Dispersible Tablets was given to the patients in the control group， 20 mg each time， once a day， orally； Shugan Hewei Formula was given to those in the treatment group， a dose a day， twice a day， orally. The treatment for both groups lasted for 6 weeks. Before and after treatment， HAMD scores and KPS scores were observed； the change of cerebral neurotransmitters levels in the brain of patients were detected； IL-6 and TNF-α in serum were tested by ELISA. Results HAMD scores in the two groups decreased markedly after treatment （P0.05）. HAMD scores in treatment group was less than that in control group after treatment （P0.05）. KPS scores increased in treatment group after treatment， and were better than the control group （P0.05）. The contents of NE， 5-HT increased， IL-6 and TNF-αdecreased in both groups after treatment （P0.05）. The contents of NE and 5-HT in the treatment group were higher than the control group after treatment， whil