目的 探討圣·約翰草提取物片聯(lián)合艾司西酞普蘭治療抑郁癥的臨床療效。方法 納入2021年1月—2024年7月廈門市仙岳醫(yī)院收治的116例抑郁癥患者的病例資料，進行回顧性分析研究，按治療方案不同分為對照組和治療組，每組各58例。對照組口服草酸艾司西酞普蘭片，初始劑量10 mg/d，晨間餐后頓服；根據(jù)患者耐受性及療效，7 d后可調(diào)整至20 mg/d。治療組以對照組用藥為基礎(chǔ)，加用圣∙約翰草提取物片口服治療，1片/次，3次/d，用藥期間需避免強光直射皮膚。兩組療程8周。觀察兩組臨床療效和治療前和治療第2、4、6、8周17項漢密爾頓抑郁量表（HAMD-17）動態(tài)評分。比較治療前后相關(guān)評分[Young躁狂評定量表（YMRS）、失眠嚴重程度指數(shù)（ISI）、90項癥狀自評量表（SCL-90）、36項健康調(diào)查簡表（SF-36）]、中性粒細胞與淋巴細胞比值（NLR）、系統(tǒng)免疫炎癥指數(shù)（SII）和血清白細胞介素-6（IL-6）水平。結(jié)果 治療組總有效率是94.83%，顯著高于對照組的82.76%（P＜0.05）。治療后（第2、4、6、8周）HAMD-17動態(tài)評分顯示，兩組均較同組治療前顯著降低（P＜0.05）；治療組均低于對照組同期（P＜0.05）。治療后，相關(guān)評分顯示，兩組YMRS、ISI、SCL-90評分降低，而SF-36評分增加（P＜0.05）；且治療后，治療組評分變化幅度更顯著（P＜0.05）。治療后炎癥指標(biāo)顯示，兩組NLR、SII和血清IL-6水平下降（P＜0.05）；且治療組降低幅度更顯著（P＜0.05）。結(jié)論 圣∙約翰草提取物片聯(lián)合艾司西酞普蘭治療抑郁癥能進一步增強抗抑郁效果，減輕患者機體炎癥損害，促進患者情緒癥狀、睡眠障礙好轉(zhuǎn)，利于其身心健康恢復(fù)，值得臨床推廣應(yīng)用。

Objective To investigate the clinical efficacy of St. John's Wort Extract Tablets combined with escitalopram in treatment of depression. Methods A retrospective analysis was conducted on the case data of 116 patients with depression admitted to Xiamen Xianyue Hospital from January 2021 to July 2024. They were divided into two groups (58 cases each) according to different treatment plans. According to different treatment plans, they were divided into control group and treatment group, with 58 cases in each group. Patients in control group were po administered with Escitalopram Oxalate Tablets, with an initial dosage of 10 mg/d, taken all at once after morning meals. According to the patients’ tolerance and therapeutic effect, the dosage can be adjusted to 20 mg/d after 7 d. Patients in treatment group were po administered with St. John's Wort Extract Tablets on basis of control group, 1 tablet/time, 3 times daily. During the medication period, direct exposure of strong light to the skin should be avoided. The treatment courses of two groups were 8 weeks. The clinical efficacy of two groups and the dynamic scores of HAMD-17 before treatment and at the 2nd, 4th, 6th, and 8th weeks of treatment were observed. The relevant scores (YMRS, ISI, SCL-90, and SF-36 scores], NLR, SII, and IL-6 before and after treatment were compared. Results The total effective rate of treatment group was 94.83%, significantly higher than that of control group (82.76%) (P < 0.05). The dynamic HAMD-17 scores after treatment (at weeks 2, 4, 6, and 8) showed that both groups were significantly lower than those before treatment in same group (P < 0.05). The levels in treatment group were all lower than those in control group at same period (P < 0.05). After treatment, the relevant scores showed that the YMRS, ISI, and SCL-90 scores in both groups decreased, but the SF-36 score increased (P < 0.05). Moreover, after treatment, the score change range of treatment group was more significant (P < 0.05). The inflammatory indicators after treatment showed that the levels of NLR, SII, and serum IL-6 in both groups decreased (P < 0.05). And the reduction amplitude in treatment group was more significant (P < 0.05). Conclusion St. John's Wort Extract Tablets combined with escitalopram in treatment of depression can further enhance the antidepressant effect, reduce the inflammatory damage of the patients’ body, promote the improvement of patients’ emotional symptoms and sleep disorders, and facilitate the recovery of their physical and mental health. It is worthy of clinical promotion and application.

R971

廈門市衛(wèi)生健康高質(zhì)量發(fā)展科技計劃項目（2024GZL-GG93）