參芪解郁顆粒聯合鹽酸帕羅西汀治療產后抑郁癥的效果

【摘要】 目的：探討參芪解郁顆粒聯合鹽酸帕羅西汀治療產后抑郁癥（PPD）的效果。方法：選擇2019年6月—2021年12月中國人民解放軍聯勤保障部隊第九〇八醫院收治的80例PPD患者作為研究對象，隨機分為對照組和觀察組，每組40例。對照組給予鹽酸帕羅西汀治療，觀察組在對照組基礎上給予參芪解郁顆粒治療。對比兩組療效、血清神經遞質水平、雌激素（E2）與孕激素（P）水平、不良反應。結果：觀察組療效優于對照組（Plt;0.05）。治療6周后，兩組血清5-羥色胺（5-HT）、去甲腎上腺素（NE）、多巴胺（DA）水平均較治療前提高，且觀察組均高于對照組（Plt;0.05）；兩組的E2、P水平均較治療前提高（Plt;0.05），但兩組間比較，差異均無統計學意義（Pgt;0.05）。觀察組、對照組的不良反應發生率分別為7.50%、12.50%，兩組間比較，差異無統計學意義（Pgt;0.05）。結論：參芪解郁顆粒聯合鹽酸帕羅西汀能調節PPD患者的神經遞質水平，提升了臨床療效且不增加不良反應。

【關鍵詞】 參芪解郁顆粒 產后抑郁癥 鹽酸帕羅西汀 5-羥色胺 去甲腎上腺素 多巴胺

Effect of Shenqi Jieyu Granules Combined with Paroxetine Hydrochloride in the Treatment of Postpartum Depression/WANG Ying， CHEN Wenling， HOU Sijia， HUANG Jie， XU Fang. //Medical Innovation of China， 2023， 20（31）： 0-086

[Abstract] Objective： To explore the effect of Shenqi Jieyu Granules combined with Paroxetine Hydrochloride in the treatment of postpartum depression （PPD）. Method： A total of 80 patients with PPD admitted to the 908th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army from June 2019 to December 2021 were selected as the study subjects and randomly divided into control group and observation group， with 40 cases in each group. The control group was treated with Paroxetine Hydrochloride， and the observation group was treated with Shenqi Jieyu granules on the basis of the control group. The curative effect， serum neurotransmitter level， estrogen （E2） and progesterone （P） levels and adverse reactions were compared between the two groups. Result： The curative effect in the observation group was better than that in the control group （Plt;0.05）. After 6 weeks of treatment， the serum levels of 5-hydroxytryptamin （5-HT）， norepinephrine （NE） and dopamine （DA） in the two groups increased compared with those before treatment， and those in the observation group were higher than those in the control group （Plt;0.05）; The serum E2 and P levels of the two groups increased compared with those before treatment （Plt;0.05）， but there were no statistical differences between the two groups （Pgt;0.05）. The incidence of adverse reactions in the observation group and the control group were 7.50% and 12.50% respectively， there was no statistical difference between the two groups （Pgt;0.05）. Conclusion： Shenqi Jieyu Granules combined with Paroxetine Hydrochloride can regulate the level of neurotransmitter in patients with PPD， improves the clinical efficacy without increasing adverse reactions.

[Key words] Shenqi Jieyu Granules Postpartum depression Paroxetine Hydrochloride 5-hydroxytryptamin Norepinephrine Dopamine

First-author's address： The 908th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army， Nanchang 330001， China

doi：10.3969/j.issn.1674-4985.2023.31.019

產后抑郁癥（postpartum depression，PPD）主要在產后兩周出現，在產后4～6周的癥狀明顯，臨床表現為情緒低落、睡眠障礙、注意力不集中、困倦、易流淚等。調查顯示全球范圍內初產婦PPD的發生率為8.00%～13.00%，國內的發病率為5.45%～20.00%[1-2]。不僅嚴重影響產婦的日常生活，還對嬰兒的生長發育有不利影響，甚至會發展為成年后精神病，故應積極治療。鹽酸帕羅西汀為臨床常用治療PPD的藥物之一，其通過調節突觸間隙的血清5-羥色胺（5-HT）濃度發揮抗抑郁效果[3]。中醫藥用于治療抑郁癥也取得了一定進展，且中藥治療易被患者接受、副作用少?！?br>