目的 評價九味鎮(zhèn)心顆粒聯(lián)合舍曲林應(yīng)用于產(chǎn)后抑郁癥的有效性和安全性。方法 選取2012年8月-2015年3月在天津市安定醫(yī)院就診的產(chǎn)后抑郁癥患者87名，隨機分成對照組（43例）和治療組（44例）。對照組口服鹽酸舍曲林片，1片/次，1次/d。治療組在對照組的基礎(chǔ)上口服九味鎮(zhèn)心顆粒，1袋/次，3次/d。兩組患者均連續(xù)治療8周。評價兩組患者治療前后臨床療效，比較漢密頓抑郁量表（HAMD）評分和血清雌二醇、孕酮水平。結(jié)果 治療2、4、8周后，對照組的總有效率分別為16.3%、44.2%、72.1%，均顯著低于同期治療組的36.4%、65.9%、86.4%，兩組總有效率比較差異具有統(tǒng)計學意義（P<0.05）。治療4、8周后，兩組患者HAMD評分均顯著下降，且治療2周后治療組患者HAMD評分顯著下降，同組比較差異具有統(tǒng)計學意義（P<0.05）；治療8周后，治療組患者HAMD評分顯著低對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組患者雌二醇水平顯著升高，孕酮水平顯著降低，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且治療組患者性激素水平改善效果優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 九味鎮(zhèn)心顆粒聯(lián)合舍曲林對產(chǎn)后抑郁癥有明顯的治療作用，具有一定的臨床推廣應(yīng)用價值。

Objective To evaluate the effect and safety of Jiuwei Zhenxin Granules combined with sertraline in treatment of postpartum depression. Methods Patients (87 cases) with postpartum depression in Tianjin Anding Hospital from August 2012 to March 2015 were randomly divided into control (43 cases) and treatment (44 cases) groups. Patients in the control group were po administered with Sertraline Hydrochloride Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Jiuwei Zhenxin Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy, HAMD score, serum estradiol and progesterone level in two groups before and after treatment were evaluated. Results After treatment for 2, 4, 8 weeks, the clinical efficacies in the control group were 16.3%, 44.2%, and 72.1%, which were significantly lower than 36.4%, 65.9%, and 86.4% in the same period of treatment group, and there were differences between two groups (P < 0.05). After treatment for 4 and 8 weeks, HAMD score in two groups was significantly decreased, and HAMD score in the treatment group was significantly decreased after treatment for 2 weeks, the difference was statistically significant in the same group (P < 0.05). After treatment for 8 weeks, HAMD score in the treatment group was significantly lower than that in the control group, with significant difference between two groups (P < 0.05). After treatment, serum estradiol in two groups was significantly increased, but progesterone level was significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the improvement effect of sex hormone level in the treatment group was significantly better than that in the control group, with significant difference between two groups (P < 0.05). Conclusion Jiuwei Zhenxin Granules combined with sertraline has obvious therapeutic effect in treatment of postpartum depression, which has a certain clinical application value.