本文選題：抑郁癥 + 舒肝解郁膠囊　； 參考：《新鄉(xiāng)醫(yī)學(xué)院》2017年碩士論文

【摘要】：背景近年來,抑郁癥的患病率呈現(xiàn)出逐漸上升的趨勢,且其致殘率較高,嚴重影響患者的社會功能,已經(jīng)成為嚴重的社會公共問題。由于抑郁癥的病因不明、機制不清,導(dǎo)致藥物起效緩慢、治療率不高、容易復(fù)發(fā),因此使得抑郁癥的治療的相關(guān)研究成為臨床研究的熱門話題。本文采用祖國醫(yī)學(xué)的理論,對抑郁癥的臨床相及治療進行了研究。目前有研究認為超敏c反應(yīng)蛋白可能是抑郁癥一個重要的指標(biāo),本文對其進行探討。目的觀察舒肝解郁膠囊與舍曲林片治療抑郁癥的療效、不良反應(yīng),觀察抑郁癥患者治療前后超敏c反應(yīng)蛋白水平、認知功能的變化。方法本研究根據(jù)入組順序隨機分入組,納入2016年1月至2016年12月于河南省精神衛(wèi)生中心門診或病房接受治療的輕、中度抑郁癥患者96例。將抑郁癥患者分為2組:舒肝解郁組和舍曲林組(共同稱為“患者組”),另設(shè)健康對照組40例。采用漢密頓抑郁量表(HAMD)評估患者組在治療前及治療第2、第4、第6周末的抑郁癥狀嚴重程度,應(yīng)用韋氏智力測驗(WAIS-RC)評估患者組在治療前及治療后第6周末的認知功能,采用副反應(yīng)量表(TESS)觀察患者組治療后第2、第4、第6周末藥物治療的副反應(yīng),同時觀察三組治療前及患者組治療后第2、第4、第6周末的hsCRP水平。數(shù)據(jù)統(tǒng)計采用SPSS19.0進行統(tǒng)計分析,包括描述統(tǒng)計、t檢驗和χ2檢驗、方差分析等。結(jié)果舒肝解郁組和舍曲林組在一般人口學(xué)資料如性別、年齡、受教育程度、婚姻狀況等方面的無顯著差異(P0.05),舒肝解郁組、舍曲林組與健康對照組在受教育水平方面差異顯著(P0.001)。舒肝解郁組和舍曲林組在治療前及治療第2、4、6周末的HAMD評分多變量方差分析結(jié)果得到F值為37.33,P值小于0.01,說明4個治療時段HAMD評分差異有顯著統(tǒng)計學(xué)意義;同時得出治療時間與治療分組之間交互作用的F值為0.705,P值大于0.05,說明舒肝解郁組和舍曲林兩組之間的HAMD評分無明顯差異,無統(tǒng)計學(xué)意義(P0.05)。在治療前的hsCRP水平方面,舒肝解郁組和舍曲林組均高于健康對照組,而舒肝解郁組和舍曲林組在治療前后hsCRP水平無明顯差異(P0.05)。在副反應(yīng)發(fā)生率方面,舒肝解郁組(發(fā)生率為6.25%)低于舍曲林組(發(fā)生率為26%),有顯著性差異(χ2=5.378,P0.05)。在認知功能方面,治療前,三組在領(lǐng)悟、算術(shù)、數(shù)字廣度、詞匯、數(shù)字符號總數(shù)和正確數(shù)、填圖分測驗存在顯著差異(P0.05);治療后,舒肝解郁組在領(lǐng)悟、算術(shù)、詞匯和數(shù)字符號分測驗中的成績高于治療前,而相似性分測驗的成績低于治療前,差異顯著(t=-3.218,P=0.002;t=-2.314,P=0.038;t-=2.974,P=0.005;t=-3.151,P=0.037)。舍曲林組經(jīng)治療,其數(shù)字廣度分測驗、詞匯分測驗、數(shù)字符號分測驗的成績均優(yōu)于治療前,差異有統(tǒng)計學(xué)意義(t=-3.241,P=0.013;t=-3.241,P=0.013;t=-3.112,P=0.001)。結(jié)論舒肝解郁膠囊是一種既有效又安全的抗抑郁藥。超敏c-反應(yīng)蛋白與抑郁癥的關(guān)系密切。抑郁癥患者存在明顯的認知功能障礙,舒肝解郁膠囊、舍曲林片治療后認知功能有改善。
[Abstract]:In recent years, the prevalence of depression has been rising gradually, and its high disability rate, which seriously affects the social function of the patients, has become a serious social public problem. Because of the unknown cause of depression, the mechanism is not clear, the effect of the drug is slow, the rate of treatment is not high, and it is easy to recur, so it makes the treatment of depression. Research has become a hot topic in clinical research. This article uses the theory of Chinese medicine to study the clinical phase and treatment of depression. At present, it is considered that hypersensitive C reaction protein may be an important indicator of depression. Effect, adverse reaction, observation of the level of hypersensitive C reaction protein and the change of cognitive function before and after treatment in the patients with depression. Methods the study was randomly divided into groups according to the order of entry and included 96 mild, moderate depressive patients who were treated in the outpatient or ward of the mental health center of Henan province from January 2016 to December 2016. The patients were divided into 2 groups. The Shugan Jieyu group and sertraline group (commonly referred to as "patient group") and 40 healthy controls were set up by the Hamilton Depression Scale (HAMD) to assess the severity of depressive symptoms in the patients before and at the second, fourth, and sixth weekends of the treatment group. The Wechsler intelligence test (WAIS-RC) was used to assess the cognitive work of the patients before and after the sixth weekend of treatment. Yes, by using the side reaction scale (TESS) to observe the side effects of the second, fourth, and sixth weeks after treatment in the patient group. At the same time, the hsCRP levels of the three groups before and after the treatment were observed at second, fourth, and sixth weeks. The data were statistically analyzed by SPSS19.0, including the descriptive statistics, the t test, the chi 2 test and the variance analysis. There was no significant difference in general demographic data such as sex, age, education and marital status (P0.05), Shugan Jie Yu group, sertraline group and healthy control group (P0.001) in general demographic data such as sex, age, education, and marital status. The HAMD score of Shugan Jie Yu group and ralatin group before and after 2,4,6 weekend was more than that of Shugan Jie Yu group and sertraline group. The results of variable variance analysis showed that the F value was 37.33 and the P value was less than 0.01, indicating that the difference in HAMD score of the 4 periods of treatment was statistically significant. At the same time, the F value of the interaction between the treatment time and the treatment group was 0.705 and the P value was greater than 0.05, indicating that there was no significant difference in the HAMD score between the Shugan Jie Yu group and the sertraline two groups, and there was no statistical difference. P0.05. In the level of hsCRP before treatment, the Shugan Jie Yu group and sertraline group were all higher than those in the healthy control group, but there was no significant difference between the Shugan Jie Yu group and sertraline group before and after the treatment (P0.05). In the incidence of side effects, the group of Shugan Jie Yu (6.25%) was lower than the sertraline group (26%), and there were significant differences (the incidence of the group was 6.25%). Chi 2=5.378, P0.05). In cognitive function, before treatment, the three groups were in comprehension, arithmetic, digital breadth, vocabulary, total number of symbols and correct numbers, and there were significant differences (P0.05) in the mapping test. After treatment, the scores of the Shugan depressive group were higher than those before the treatment in the comprehension, arithmetic, vocabulary and digital sign test, while the results of the similarity test were low. Before treatment, the difference was significant (t=-3.218, P=0.002; t=-2.314, P=0.038; t-=2.974, P=0.005; t=-3.151, P=0.037). The sertraline group was treated with digital span test, vocabulary test, and digital symbol test. The difference was statistically significant (t=-3.241, P=0.013; t=-3.241, P=0.013; The Yu capsule is an effective and safe antidepressant. The hypersensitive c- reactive protein is closely related to depression. The patients with depression have obvious cognitive impairment, Shugan Jieyu capsule, and sertraline tablet after treatment.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R749.4

【參考文獻】

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本文編號：1926644