金匮肾气丸改善抑郁症病人疲劳感的临床研究

doi:10.3969/j.issn.1006-7795.2017.02.010

摘要/Abstract

摘要： 目的探讨金匮肾气丸改善肾虚肝郁型抑郁症病人疲劳感的疗效。方法 60例抑郁症病人按数字表法随机分为研究组（金匮肾气丸方合并草酸艾司西酞普兰治疗）和对照组（草酸艾司西酞普兰治疗），每组30例，对照组给予草酸艾司西酞普兰治疗，开始剂量10 mg/d，2周内增至20 mg/d，每天1次，晨起顿服。研究组在此基础上加用金匮肾气丸（制附片6 g，桂枝12 g，牛膝10 g，车前子15 g，熟地黄10 g，泽泻10 g，山萸肉12 g，淮山药10 g，茯苓30 g，牡丹皮12 g，1日1剂，早晚各1次，每次200 mL），2组均治疗8周。在治疗前及治疗的2、4、8周末分别采用疲劳量表-14（Fatigue Scale-14，FS-14）、疲劳自评量表（Fatigue Self Assessment Scale，FSAS）、汉密尔顿抑郁量表（Hamilton Depression Scale，HAMD）评分，并评价治疗效果。结果研究组总有效率为86.7%，对照组为60%，差异有统计学意义（P=0.039）。研究组FS-14量表评分比较，治疗2周、4周、8周末研究组均低于对照组，差异有统计学意义（P<0.01），重复测量方差分析显示，评定时间主效应显著（F=495.021，P=0.000），两组治疗2周末、4周末、8周末的FS-14评分均较治疗前降低，评定时间组别的交互作用显著（F=40.923，P=0.000），组间效应显著（F=17.516，P=0.000）。研究组FSAS量表评分比较，治疗2周、4周、8周末研究组均低于对照组，差异有统计学意义（P<0.05），重复测量方差分析显示，评定时间主效应显著（F=2 687.437，P=0.000），2组治疗2周末、4周末、8周末的FSAS评分均较治疗前降低，评定时间组别的交互作用显著（F=574.799，P=0.000），组间效应显著（F=8.087，P=0.006）。研究组HAMD评分治疗 2、4、8周末均较对照组降低，差异有统计学意义（P<0.05），重复测量方差分析显示，评定时间主效应显著（F=317.61，P=0.000），2组治疗2周末、4周末、8周末的HAMD评分均较治疗前降低，评定时间组别的交互作用显著（F=9.374，P=0.001），组间效应显著（F=4.593，P=0.037）。结论金匮肾气丸治疗伴发疲劳感的抑郁症病人疗效显著，起效更快，值得临床推广应用。

关键词: 金匮肾气丸, 抑郁症, 疲劳感, 肾虚肝郁型

Abstract: Objective To evaluate the effectiveness of Jinkui Shenqi Pill in improving the fatigue of depression patients with kidney deficiency and liver stagnation. Methods Sixty depression patients were randomly divided into two groups:trial group of 30 cases and control group of 30 cases. The patients in the control group were treated with escitalopram oxalate,at a starting dose of 10 mg/d, at 2 weeks increased to 20 mg/d, once a day, taken in the morning at a draught. And the control group were treated with Jinkui Shenqi Pill (Zhipipian 6 g, Guizhi 12 g, Achyranthes 10 g, Plantago 15 g, Rehmannia 10 g, Alisma orientalis 10 g, cornus 12 g, Chinese yam and medicine 10g, Poria 30g, moutan 12g, one dose per day, divided to be taken twice, in the morning and evening, each time 200 mL was taken) combined with escitalopram oxalate. The treatment course was 8 weeks. The Hamilton Depression Scale (HAMD), Fatigue Self Assessment Scale (FSAS) and the Fatigue Scale-14 (FS-14) were used before and at the end of 2, 4 and 8 weeks, respectively. Results The total effective rate was 86.7% in the trial group and 60% in the control group, the difference was statistically significant (P<0.05). FS-14 score was significantly lower than that of the trial group at 2 weeks, 4 weeks and 8 weeks, the difference was significant (P<0.01). Repeated measures analysis of variance revealed a significant main effect of time (F=495.021,P=0.000), FS-14 scores of the two groups were significantly lower than those before treatment, evaluation of the interaction time groups was significant (F=40.923,P=0.000), a significant effect between groups (F=17.516, P=0.000). FSAS score was significantly lower than that of the trial group at 2 weeks, 4 weeks and 8 weeks, the difference was significant (P<0.05 or P<0.01). Repeated measures analysis of variance revealed a significant main effect of time (F=2 687.437,P=0.000), FSAS scores of the two groups were significantly lower than those before treatment, evaluation of the interaction time groups was significant (F=574.799, P=0.000), a significant effect between groups (F=8.087,P=0.006). The HAMD score of the trial group was significantly lower than that of the control group at the end of 2, 4 and 8 weeks (P<0.05 or P<0.01). Repeated measures analysis of variance revealed a significant main effect of time (F=9.374,P=0.001), the HAMD scores of the two groups were significantly lower than those before treatment, evaluation of the interaction time groups was significant (F=9.374, P=0.001), a significant interacting effect between groups (F=4.593, P=0.037). Conclusion Jinkui Shenqi pill could significantly improve the fatigue of depression patients and it is worthy of clinical application.

Key words: Jinkui Shenqi Pill, depression, fatigue, kidney deficiency and liver stagnation

中图分类号:

R749.4

李苗, 袁国桢, 王群松, 周振和, 刘亮. 金匮肾气丸改善抑郁症病人疲劳感的临床研究[J]. 首都医科大学学报, 2017, 38(2): 197-201.

Li Miao, Yuan Guozhen, Wang Qunsong, Zhou Zhenhe, Liu Liang. Clinical study of Jinkui Shenqi Pill to improve the fatigue of depression patients[J]. Journal of Capital Medical University, 2017, 38(2): 197-201.

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