安神解郁汤与帕罗西汀治疗精神分裂症后抑郁的疗效比较

胡红涛

(武汉市汉口医院，武汉 430000)

摘要：目的探讨安神解郁汤和帕罗西汀在治疗精神分裂症后抑郁的临床效果。方法选取2009年3月—2013年7月在我院精神科住院治疗的患者96例，将患者随机分为治疗组48例(安神解郁汤组)和对照组48例(帕罗西汀组),并分别在治疗前、治疗后1、2、4、6周对2组进行汉密尔顿抑郁量表(HAMD-17)评分，比较临床治疗效果，采用不良反应量表(TESS)评定不良反应。结果在第1周治疗后开始起效，各组在6周治疗完成后与治疗前相比差异具有显著统计学意义(t=25.987、25.872，P<0.01)，2组的临床疗效差异无统计学意义(χ2=0.123,P>0.05)，而治疗组的不良反应较对照组明显减少，差异具有显著统计学意义(χ2=6.095,P<0.05)。结论中医对抑郁症的治疗则侧重于人体整个调节系统的疗效,中药成分能够兴奋下丘脑和海马多巴胺神经，抑制5-羟色胺的释放而减轻抑郁症状，通过大脑皮质的兴奋性抑制增强起到镇静作用。

关键词：精神分裂后抑郁；安神解郁汤；帕罗西汀

DOI:10.13463/j.cnki.jlzyy.2015.08.012

中图分类号：R711.7文献标志码： A

文章编号：1003-5699(2015)08-0794-03

作者简介:胡红涛(1978-),男，硕士，主治医师，主要从事精神分裂症和睡眠障碍诊治研究。

收稿日期:(责任编辑：王丹2014-2-10)

Comparison of Anshen Jieyu decoction and Paroxetine in treatment of schizophrenic depression

HU Hongtao

(Wuhan Hankou Hospital of Hubei Province,Wuhan 430000,China)

Abstract:ObjectiveTo investigate the clinical effect of Anshen Jieyu decoction and paroxetine in the treatment of schizophrenia depression.MethodsThe 96 cases of schizophrenia depression patients have been chosen randomly in our hospital from March 2009 to July 2013 and were divided into control group (Anshen Jieyu decoction group)and observation group(paroxetine group).The therapeutic efficacy was evaluated at the end of the 1 st,2 nd,4 th and 6 th week by scoring according Hamilton Rating Scale for Depression (HAMD-17) and clinical therapeutic effect;and adverse reaction was evaluated by Treatment Emergent Symptoms Scale (TESS).ResultsThe medicine worked in the first week after treatment,and the difference was statistically significant compared with before treatment after six weeks’treatment(t=25.987,25.872，P<0.01),while the difference of clinical therapeutic effect was not statistically significant(χ2=0.123，P>0.05);but adverse reactions in the treatment group decreased significantly compared with the control group and the difference was statistically significant(χ2=6.095，P<0.05).ConclusionThere are high effect and safety in Anshen Jieyu decoction and worth to be applied to clinic.

Keywords:schizophrenic depression;Anshen Jieyu decoction;paroxetine

精神分裂症是一组病因未明的重性精神病，多在青壮年缓慢或亚急性起病，表现为思维障碍、情感反应不协调等，在病情缓解后常继发抑郁状态，有数据显示抑郁状态的发生率在精神分裂症患者中为30%～60%,远高于正常人群的发生率10%[1]。抑郁状态在精神分裂症各阶段均可发生，患者社会心理功能减弱或丧失，且受社会、家庭环境的影响，易产生自卑、焦虑的负面情绪，严重抑郁患者自杀行为的发生率明显增高[2]。虽然市场上各种抗抑郁药物在不断被研发应用，然而抗抑郁药物作为化学合成药品不仅价格昂贵，且不良反应较大，仍未能取得令人十分满意的疗效。……