目的 探討舒眠膠囊聯(lián)合曲唑酮治療老年抑郁癥的臨床療效。方法 選取2023年2月—2024年6月河北省第三榮軍優(yōu)撫醫(yī)院收治的84例老年抑郁癥患者，按隨機數(shù)字表法分為對照組和治療組，每組各42例。對照組睡前口服鹽酸曲唑酮片，起始劑量100 mg/次，1次/d，服用3 d后增加50 mg/次。治療組在對照組治療基礎(chǔ)上晚飯后、臨睡前口服舒眠膠囊，3粒/次，2次/d。兩組療程6周。觀察兩組臨床療效，比較兩組治療前、治療2、4、6周17項漢密爾頓抑郁量表（HAMD-17）評分及治療前后中醫(yī)癥狀總積分、老年抑郁癥狀問卷（GDI）、簡式抑郁-焦慮-壓力量表（DASS-21）和睡眠狀況自評量表（SRSS）評分，中性粒細胞與淋巴細胞比值（NLR）、紅細胞分布寬度（RDW）和血清C反應(yīng)蛋白（CRP）水平變化。結(jié)果 治療組總有效率是95.24%，顯著高于對照組的80.95%（P＜0.05）。治療2、4、6周兩組HAMD-17評分均明顯低于治療前（P＜0.05）；治療后各時點，治療組HAMD-17評分均低于對照組同期（P＜0.05）。治療后，兩組中醫(yī)癥狀總積分和GDI、DASS-21、SRSS評分低于組內(nèi)治療前（P＜0.05）；治療后，治療組中醫(yī)癥狀總積分和GDI、DASS-21、SRSS評分低于對照組（P＜0.05）。治療后，兩組NLR、RDW和血清CRP水平均顯著下降（P＜0.05），且治療后治療組NLR、RDW和血清CRP水平均低于對照組（P＜0.05）。結(jié)論 舒眠膠囊聯(lián)合曲唑酮治療老年抑郁癥能有效減輕抑郁癥狀及伴隨的臨床表現(xiàn)，促進情緒狀態(tài)、睡眠狀況及生活質(zhì)量好轉(zhuǎn)，且利于機體炎癥反應(yīng)進一步控制，整體療效較佳，值得臨床推廣應(yīng)用。

Objective To explore the clinical efficacy of Shumian Capsules combined with trazodone in treatment of senile depression. Methods A total of 84 patients with senile depression admitted to Hebei Province Third Military Special Care Hospital from February 2023 to June 2024 were selected and divided into control group and treatment group according to random number table method, with 42 cases in each group. Patients in control group were po administered with Trazodone Hydrochloride Tablets before going to bed, the initial dose was 100 mg/time, once daily, and 50 mg/time was increased after 3 d of administration. Patients in treatment group were po administered with Shumian Capsules after dinner and before going to bed on basis of control group, 3 capsules/time, twice daily. Both groups were treated for 6 weeks. The clinical efficacy of two groups was observed, and 17 Hamilton Depression Scale (HAMD-17) scores were compared between two groups before treatment, and 2, 4 and 6 weeks of treatment. The scores of total Chinese medicine symptom score, senile depressive Symptom Questionnaire (GDI), simplified depression-Anxiety-Stress Scale (DASS-21), Sleep status Self-rating Scale (SRSS), neutrophil to lymphocyte ratio (NLR), red blood cell distribution width (RDW), and serum C-reactive protein (CRP) in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 95.24%, which was significantly higher than that of the control group (80.95%, P < 0.05). HAMD-17 scores in 2, 4 and 6 weeks of treatment were significantly lower than before treatment (P < 0.05). HAMD-17 scores in treatment group were lower than those in control group at all time points after treatment (P < 0.05). After treatment, the total score of TCM symptoms, the scores of GDI, DASS-21, and SRSS in two groups were lower than before treatment (P < 0.05). After treatment, the total TCM symptom score, GDI, DASS-21, and SRSS scores in treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of NLR, RDW, and serum CRP in both groups were significantly decreased (P < 0.05), and the levels of NLR, RDW, and serum CRP in treatment group were lower than those in control group (P < 0.05). Conclusion Shumian Capsules combined with trazodone in treatment of senile depression can effectively reduce depressive symptoms and accompanying clinical manifestations, and can promote the improvement of emotional state, sleep status and life quality, and further control the inflammatory response of the body, the overall effect is good, which is worthy of clinical promotion and application.

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