舒肝调心方治疗恶性肿瘤抑郁症55例

Shugan Tiaoxin Decoction in Treating 55 Cases with Malignant Tumor Combined with Depression

摘要:

目的: 探讨舒肝调心方治疗恶性肿瘤抑郁症的疗效及对血清炎性因子的影响. 方法: 采用随机按数字表法将110例符合条件的患者分为对照组和观察组各55例.对照组采用盐酸氟西汀胶囊,起始剂量20 mg·d^-1,早餐后服用,用药2周后根据病情调整剂量;观察组在对照组治疗的基础上加服舒肝调心方,1剂/d.两组疗程均为8周.进行治疗前后汉密尔顿抑郁量表(HAMD)和抑郁自评量表(SDS)评分;进行治疗前后欧洲癌症研究与治疗组织(EORTC)的生活质量量表(QLQ-BR30)评分;检测治疗前后血清白细胞介素1β(IL-1β)、白细胞介素2(IL-2)、白细胞介素6(IL-6)及肿瘤坏死因子-α(TNF-α)水平. 结果: ①抑郁疗效:治疗后观察组抑郁疗效优于对照组(P<0.05),观察组抑郁程度轻于对照组(P<0.01),观察组HAMD和SDS评分低于对照组(P<0.01).②生活质量评价:治疗后观察组角色功能、情绪功能和整体生活质量评分均高于对照组(P<0.05,P<0.01);治疗后观察组疼痛、失眠、食欲丧失、便秘、腹泻评分低于对照组(P<0.05,P<0.01).③炎性因子水平变化:治疗后观察组IL-1β,IL-6及TNF-α水平低于对照组,IL-2水平高于对照组(P<0.01). 结论: 舒肝调心方能改善恶性肿瘤抑郁症患者的抑郁程度、减轻抑郁症状、提高患者生活质量,其作用机制可能是通过调节血清炎性因子来实现的.

Abstract:

Objective: To discuss the curative efficacy of Shugan Tiaoxin decoction and its influence to on serous inflammatory factors in treating malignant tumor combined with depression. Method: One hundred and ten eligible patients were randomly divided into control group (55 cases) and observation group (55 cases) by random number table. Patients in control group received Fluoxetine capsules (starting dose was 20 mg/day, taken after breakfast, and the dose was adjusted according to patients' state after 2 weeks). Based on the treatment of control group, patients in observation group added 1 dose Shugan Tiaoxin decoction daily. Patients in two groups received a 8-week period of treatment. Before and after treatment, the Hamilton depression rating scale (HAMD) and the self-rating depression scale were graded. The quality of life scale (QLQ-BR30) of European Organization for Research and Treatment of Cancer (EORTC) was graded. Levels of serous interleukin-1β (IL-1β), interleukin-2 (IL-2), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected. Result: The depressant action in observation group was superior to that in control group (P<0.05), and depression symptom in observation group was better than that in control group(P<0.01), and scores of HAMD and SDS in observation group were lower than those in control group (P<0.01). Scores of role function, emotional function and global quality of life in observation group were all higher than those in control group (P<0.05, P<0.01). Scores of pain, insomnia, appetite loss, constipation and diarrhea in observation group were lower than those in control group (P<0.05, P<0.01). Levels of IL-1β,IL-6 and TNF-α in observation group were lower than those in control group, and level of IL-2 was higher than that in control group (P<0.01). Conclusion: Shugan Tiaoxin decoction could ameliorate depression symptom, reduce symptoms of depression and improve patients' quality of life in treating malignant tumor combined with depression. Its mechanism of action may be related to the regulation of serous inflammatory factors.