逍遥散合半夏厚朴汤对肝郁脾虚型抑郁症患者认知功能和事件相关电位P300的影响

陈克龙; 陈凌; 宋成城; 黎斌

doi:10.16766/j.cnki.issn.1674-4152.002425

逍遥散合半夏厚朴汤对肝郁脾虚型抑郁症患者认知功能和事件相关电位P300的影响

doi: 10.16766/j.cnki.issn.1674-4152.002425

温州市中医院神经内科，浙江温州 325000

基金项目:

浙江省中医药科技计划项目 2022ZH338

浙江省中医药科技计划项目 2016ZA179

详细信息

通讯作者:
陈克龙, E-mail: 247360354@qq.com

中图分类号: R749.41 R289.56
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出版历程
- 收稿日期: 2021-12-14
- 网络出版日期: 2022-08-20

Effect of Xiaoyao Powder and Banxia Houpu Decoction on cognitive function and event-related potential P300 in patients with liver depression and spleen deficiency depression

Department of Neurology, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的观察逍遥散合半夏厚朴汤对肝郁脾虚型抑郁症患者认知功能和事件相关电位P300的影响情况。方法选取2019年4月—2021年10月浙江中医药大学附属温州市中医院收治的60例肝郁脾虚型抑郁症患者为研究对象，按随机数字表法分为研究组和对照组，每组30例。对照组患者予以艾司西酞普兰片口服治疗，研究组患者予以逍遥散合半夏厚朴汤口服治疗。分别于治疗前和治疗8周后，评价患者抑郁程度和认知功能变化情况，测定患者事件相关电位P300相关指标变化情况，观察药物不良反应情况。结果治疗8周后，研究组患者HAMD评分[(12.67±1.62)分]显著低于对照组[(15.37±1.42)分，t=6.838，P < 0.001]。治疗8周后，研究组患者操作智商(PIQ)、言语智商(VIQ)和总智商(FIQ)分值[(100.13±3.47)分、(104.57±3.04)分、(102.53±2.37)分]均显著高于对照组[(96.97±3.20)分、(102.37±2.85)分、(99.87±2.21)分，均P < 0.05]，研究组患者MQ分值[(77.77±3.32)分]显著高于对照组[(73.27±3.04)分，t=5.468，P < 0.001]，研究组患者总测验数、持续错误数和随机错误数等WCST评分指标均显著低于对照组(均P < 0.05)。治疗8周后，研究组患者事件相关电位P300潜伏期显著低于对照组，而事件相关电位P300波幅显著高于对照组(均P < 0.05)。研究组患者药物不良反应发生率(3.33%)显著低于对照组(26.67%，χ²=4.706，P=0.030)。结论逍遥散合半夏厚朴汤可有效减轻肝郁脾虚型抑郁症患者抑郁症状严重程度，提高认知功能恢复水平，改善神经电生理状况，治疗安全性较高。
- 抑郁症 /
- 肝郁脾虚型 /
- 逍遥散合半夏厚朴汤 /
- 认知功能 /
- 事件相关电位P300
Abstract: Objective To observe the effects of Xiaoyao Powder and Banxia Houpu Decoction on cognitive function and event-related potential P300 in patients with liver depression and spleen deficiency depression. Methods Sixty patients with liver depression and spleen deficiency depression in Wenzhou Hospital of Traditional Chinese Medicine from April 2019 to October 2021 were randomly divided into study group and control group, with 30 patients in each group. The patients in the control group were treated with escitalopram tablets orally, whereas those in the study group were treated with Xiaoyao Powder and Banxia Houpu Decoction. Before and 8 weeks after treatment, the changes of depression and cognitive function were evaluated. The changes of event-related potential P300 and adverse drug reactions were observed. Results After 8 weeks of treatment, the Hamilton Depression Scale(HAMD) score of the study group [(12.67±1.62) points] was significantly lower than that of the control group [(15.37±1.42) points, t=6.838, P < 0.001]. The performances IQ (PIQ), verbal IQ (VIQ) and full intelligence quotient (FIQ) scores [(100.13±3.47) points, (104.57±3.04) points and (102.53±2.37) points, respectively] in the study group were significantly higher than those in the control group [(96.97±3.20) points, (102.37±2.85) points and (99.87±2.21) points, respectively, all P < 0.05]. The MQ scores [(77.77±3.32) points] in the study group were significantly higher than those in the control group [(73.27±3.04) points, t=5.468, P < 0.001]. The WCST score indexes of patients in the study group were significantly lower than those in the control group (all P < 0.05). The latency of event-related potential P300 in the study group was significantly lower than that in the control group, and the amplitude of event-related potential P300 was significantly higher than that in the control group (all P < 0.05). The incidence of adverse reactions in the study group (3.33%) was significantly lower than that in the control group (26.67%, χ²=4.706, P=0.030). Conclusion Xiaoyao Powder and Banxia Houpu Decoction can effectively reduce the severity of depressive symptoms in patients with liver depression and spleen deficiency depression, improve the recovery level of cognitive function and improve the neuroelectrophysiological status. They have high safety.
- Depression /
- Liver depression and spleen deficiency /
- Xiaoyao Powder and Banxia Houpu Decoction /
- Cognitive function /
- Event-related potential P300

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表 1 2组肝郁脾虚型抑郁症患者治疗前后WAIS评分比较(x±s，分)

Table 1. Comparison of WAIS scores before and after treatment in two groups of patients with depression with liver stagnation and spleen deficiency(x±s, points)

组别	例数	PIQ		VIQ		FIQ
组别	例数	治疗前	治疗8周后	治疗前	治疗8周后	治疗前	治疗8周后
对照组	30	92.73±2.95	96.97±3.20^a	98.67±3.01	102.37±2.85^a	95.84±2.24	99.87±2.21^a
研究组	30	92.37±3.20	100.13±3.47^a	98.73±2.79	104.57±3.04^a	95.97±2.06	102.53±2.37^a
t值		0.462	3.674	0.089	2.894	0.131	4.504
P值		0.646	< 0.001	0.929	0.005	0.896	＜0.001
注：与同组治疗前比较, ^aP < 0.05。

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表 2 2组肝郁脾虚型抑郁症患者治疗前后WCST评分比较(x±s)

Table 2. Comparison of WCST scores before and after treatment in two groups of patients with depression with liver stagnation and spleen deficiency(x±s)

组别	例数	总测验数		正确数		持续错误数		随机错误数		分类数
组别	例数	治疗前	治疗8周后	治疗前	治疗8周后	治疗前	治疗8周后	治疗前	治疗8周后	治疗前	治疗8周后
对照组	30	73.17±3.46	67.27±3.41^a	24.77±1.83	25.07±1.67	22.37±2.63	19.13±2.79^a	26.73±2.84	23.23±2.34^a	4.80±0.41	4.83±0.38
研究组	30	72.83±3.61	63.87±3.78^a	24.73±1.51	25.23±1.76	22.13±2.49	16.17±2.18^a	26.47±2.64	21.13±2.21^a	4.83±0.38	4.87±0.34
t值		0.365	3.654	0.092	0.367	0.353	4.589	0.367	3.571	0.294	0.429
P值		0.717	＜0.001	0.939	0.715	0.725	＜0.001	0.708	＜0.001	0.744	0.669
注：与同组治疗前比较，^aP＜0.05。

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表 3 2组肝郁脾虚型抑郁症患者治疗前后事件相关电位P300指标比较(x±s)

Table 3. Comparison of P300 indexes of event-related potential before and after treatment in two groups of patients with depression of liver stagnation and spleen deficiency type(x±s)

组别	例数	潜伏期(ms)		波幅(μV)
组别	例数	治疗前	治疗8周后	治疗前	治疗8周后
对照组	30	392.77±4.64	358.37±4.71^a	3.85±0.34	5.11±0.32^a
研究组	30	392.57±4.46	345.47±4.88^a	3.86±0.33	5.67±0.32^a
t值		0.170	10.416	0.115	6.778
P值		0.866	＜0.001	0.909	＜0.001
注：与同组治疗前比较，^aP＜0.05。

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