金匮肾气丸治疗肾虚肝郁型抑郁症的治疗效果及其对人血清神经生长因子的影响

doi:10.3969/j.issn.1006-7795.2019.02.013

摘要/Abstract

摘要： 目的探讨金匮肾气丸对肾虚肝郁型抑郁症患者人血清神经生长因子（nerve growth factor，NGF）的影响。方法 60例肾虚肝郁型抑郁症患者，采用数字表法将患者随机分为研究组30例和对照组30例，研究组口服草酸艾司西酞普兰联合金匮肾气丸方，1剂/d，分2次服用。对照组口服草酸艾司西酞普兰，20 mg/d。两组均治疗8周。在治疗前及治疗的2、4、8周末分别评定蒙哥马利抑郁量表（Montgomery-Asberg-Rating Scale，MADRS）及抑郁症中医证候要素量表，同时分别测定治疗前、后患者NGF浓度。结果研究组和对照组治疗前MADRS评分、中医证候要素量表评分差异无统计学意义（P>0.05），以量表评定时间（2、4、8周末）为组内因素、组别（研究组和对照组）为组间因素，通过重复测量方差分析可知，组内因素（MADRS）自变量效应显著[F_（2，58）=301.367，P=0.000]，组内与组间因素交互作用显著[F_（2，58）=4.022，P=0.008]，同时组间因素自变量效应显著[F_（2，58）=9.658，P=0.003]；组内因素（中医证候要素量表评分）自变量效应显著[F_（2，58）=355.130，P=0.000]，组内因素与组间因素交互作用不显著[F_（2，58）=0.970，P=0.374]，组间效应显著[F_（2，58）=5.336，P=0.024]，提示随着治疗周期的延长，研究组治疗效果优于对照组。治疗前两组NGF浓度比较，差异无统计学意义（P>0.05），治疗后研究组NGF浓度较对照组显著升高（P<0.05）。Pearson相关分析结果显示，研究组患者治疗前后NGF浓度差值与中医证候要素量表评分中肾虚评分差值呈正相关（r=0.481，P=0.007），与肝郁评分差值呈正相关（r=0.370，P=0.044）。结论金匮肾气丸可有效改善肾虚肝郁型抑郁症患者症状，同时对比单独使用草酸艾司西酞普兰的患者，其大幅度提升了血清NGF浓度。

关键词: 金匮肾气丸, 抑郁症, 肾虚肝郁型, 神经生长因子

Abstract: Objective To investigate the effect of Jinkui Shenqi Pill on serum nerve growth factor (NGF) in depression patients with kidney deficiency and liver stagnation. Methods The patients were divided into the trail group (30 cases) and control group (30 cases) by random number table method. The trail group were treated with Jinkui Shenqi Pill combined with escitalopram oxalate, one dose a day given in the morning and evening. The control group were treated with escitalopram oxalate at a dose 20 mg/d alone. The treatment course was 8 weeks. The Montgomery-Asberg-Rating Scale (MADRS) and traditional Chinese medicine (TCM) symptoms scale were measured before and at the end of weeks 2, 4 and 8, and the serum NGF levels were also recorded. Results There was no significant difference in MADRS and TCM symptoms scores before treatment between the two groups (P>0.05). The evaluation interval (2, 4, and 8 weeks) was taken as the intra-group factor and the group (trail group and control group) as the inter-group factor. By repeated measurement of variance analysis, the intra-group factor (MADRS) independent variable effect was significant[F_(2,58)=301.367,P=0.000], and the interaction between intra-group and inter-group factors was significant[F_(2,58)=4.022,P=0.008] while inter-group factor independent variable effect was significant[F_(2,58)=9.658,P=0.003];the intra-group factor (TCM symptoms) independent variable effect was significant[F_(2,58)=355.130,P=0.000], and the interaction between intra-group and inter-group factors was not significant[F_(2,58)=0.970,P=0.374],and the interaction between intra-group and inter-group factors was significant[F_(2,58)=5.336,P=0.024].It suggested that the therapeutic efficiency of the trail group is better than that of the control group. The levels of NGF before treatment in both groups were equivalent in general,with no significant difference (P>0.05).After the treatment, the NGF level in the trail group was high than that in the control group with significant difference (P<0.05). Pearson correlation analysis showed that the difference of NGF levels before and after treatment in the trail group was positively correlated with the difference of kidney deficiency score (r=0.481,P=0.007) and the difference of liver stagnation score (r=0.370,P=0.044).Conclusion Jinkui Shenqi Pills can effectively improve the symptoms of depression patients with kidney deficiency and liver depression.Compared to the patients using escitalopram oxalate alone, the serum NGF concentration in the combinatorial group increased significantly.

Key words: Jinkui Shenqi Pill, depression, kidney deficiency and liver stagnation, nerve growth factor

中图分类号:

R749.4

李苗, 王群松, 袁国桢. 金匮肾气丸治疗肾虚肝郁型抑郁症的治疗效果及其对人血清神经生长因子的影响[J]. 首都医科大学学报, 2019, 40(2): 220-225.

Li Miao, Wang Qunsong, Yuan Guozhen. Effect of Jinkui Shenqi Pill on serum nerve growth factor in depression patients with kidney deficiency and liver stagnation[J]. Journal of Capital Medical University, 2019, 40(2): 220-225.

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