目的 探討巴戟天寡糖膠囊聯(lián)合舍曲林治療產(chǎn)后抑郁癥的臨床效果。方法 選取2018年10月—2021年10月在巴彥淖爾市中醫(yī)醫(yī)院治療的120例產(chǎn)后抑郁癥患者。隨機(jī)分為對(duì)照組和治療組，每組各60例。對(duì)照組口服鹽酸舍曲林片，50 mg/次，1次/d。在此基礎(chǔ)上，治療組口服巴戟天寡糖膠囊，1粒/次，2次/d。兩組患者連續(xù)治療6周。觀察兩組患者臨床療效，比較治療前后兩組患者愛丁堡產(chǎn)后抑郁量表（EPDS）總分、24項(xiàng)漢密爾頓抑郁量表（HAMD-24）評(píng)分、阿森斯失眠量表（AIS）評(píng)分、36項(xiàng)健康調(diào)查簡表（SF-36）總分，及血清雌二醇（E₂）、皮質(zhì)醇（COR）、多巴胺（DA）、5-羥色胺（5-HT）、腫瘤壞死因子-α（TNF-α）和白細(xì)胞介素-6（IL-6）水平。結(jié)果 治療后，治療組臨床有效率為95.00%，顯著高于對(duì)照組的81.67%（P＜0.05）。治療2、4、6周時(shí)，兩組EPDS總分和HAMD-24評(píng)分均顯著低于治療前（P＜0.05），且與同期對(duì)照組相比，治療組EPDS總分和HAMD-24評(píng)分均顯著更低（P＜0.05）。與治療前相比，兩組治療后AIS評(píng)分均顯著降低，SF-36總分則均顯著升高（P＜0.05），且均以治療組的改善更顯著（P＜0.05）。治療后，兩組血清E₂、DA和5-HT水平均顯著升高，血清COR、TNF-α和IL-6水平均顯著下降（P＜0.05），且治療后治療組血清E₂、DA、5-HT、COR、TNF-α和IL-6水平明顯好于對(duì)照組（P＜0.05）。結(jié)論 巴戟天寡糖膠囊聯(lián)合舍曲林治療產(chǎn)后抑郁癥的效果確切，是控制患者抑郁樣癥狀、改善睡眠質(zhì)量及提高生活質(zhì)量的安全有效途徑，并能進(jìn)一步糾正患者神經(jīng)內(nèi)分泌紊亂及下丘腦–垂體–腎上腺皮質(zhì)（HPA）軸功能異常、抑制體內(nèi)炎癥反應(yīng)。

Objective To investigate the clinical effect of Bajitian Guatang Capsules Combined with sertraline in treatment of postpartum depression. Methods Patients (120 cases) with postpartum depression in Bayannur Chinese Medicine Hospital from October 2018 to October 2021 were randomly divided into control and treatment group, and each group had 60 cases. Patients in the control group were po administered with Sertraline Hydrochloride Tablets, 50 mg/time, once daily. Patients in the treatment group were po administered with Bajitian Guatang Capsules on the basis of the control group, 1 grain/time, twice daily. Patients in two groups were treated for 6 weeks. After treatment, the clinical evaluation was evaluated, the score of EPDS, HAMD-24, AIS, SF-36, and the levels of E₂, COR, DA, 5-HT, TNF-α, and IL-6 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 95.00%, which was significantly higher than that of the control group (81.67%) (P < 0.05). At 2, 4 and 6 weeks after treatment, the total score of EPDS and the score of HAMD-24 in two groups were significantly lower than those before treatment, and these scores in the treatment group were significantly lower than those in the control group (P < 0.05). Compared with those before treatment, the AIS score decreased significantly, and the total score of SF-36 increased significantly in two groups after treatment, and the improvement of these scores in the treatment group were more significant. Compared with those before treatment, the levels of serum E₂, DA and 5-HT increased significantly (P < 0.05), while the levels of serum COR, TNF-α and IL-6 decreased significantly in two groups (P < 0.05). After treatment, the levels of serum E₂, DA, 5-HT, COR, TNF-α and IL-6 in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Bajitian Guatang Capsules Combined with sertraline is effective in the treatment of postpartum depression, which is a safe and effective way to control depression-like symptoms, improve sleep quality and improve quality of life, and can further correct neuroendocrine disorders and hypothalamic-pituitary-adrenocortical (HPA) axis dysfunction and inhibit inflammation in vivo.

R971

巴彥淖爾市醫(yī)院2020年院內(nèi)科研課題(2020019)