Clinical Observation of Suanzaoren Tang Combined with Fluoxetine in Treatment of Depression of Liver Stagnation and Blood Deficiency Accompanied by Insomnia

Li-zhi SHANG; Meng-di MAO; Yao-yang LI; Shu JI; Xiao-hui CHEN; Wei-jie WANG; Chun-yu ZHOU; Wei WANG; Hong-chang SUN

doi:10.13422/j.cnki.syfjx.20211402

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Clinical Observation of Suanzaoren Tang Combined with Fluoxetine in Treatment of Depression of Liver Stagnation and Blood Deficiency Accompanied by Insomnia

更新时间：2021-11-12

- Clinical Observation of Suanzaoren Tang Combined with Fluoxetine in Treatment of Depression of Liver Stagnation and Blood Deficiency Accompanied by Insomnia
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 27, Issue 24, Pages: 49-54(2021)
- 作者机构：
  
  1.河南中医药大学，郑州 450046
  2.河南省仲景方药现代研究重点实验室，郑州 450046
  3.河南中医药大学第一附属医院，郑州 450006
  4.河南中医药大学第二附属医院，郑州 450005
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20211402
  CLC： R2-0;R22;R285.5;R289;R33
- Published：20 December 2021，
  
  Published Online：01 June 2021，
  
  Received：19 February 2021，
- 稿件说明：
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尚立芝,毛梦迪,李耀洋等.酸枣仁汤联合氟西汀治疗肝郁血虚型抑郁症伴失眠的临床观察[J].中国实验方剂学杂志,2021,27(24):49-54.

SHANG Li-zhi,MAO Meng-di,LI Yao-yang,et al.Clinical Observation of Suanzaoren Tang Combined with Fluoxetine in Treatment of Depression of Liver Stagnation and Blood Deficiency Accompanied by Insomnia[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(24):49-54.
尚立芝,毛梦迪,李耀洋等.酸枣仁汤联合氟西汀治疗肝郁血虚型抑郁症伴失眠的临床观察[J].中国实验方剂学杂志,2021,27(24):49-54. DOI： 10.13422/j.cnki.syfjx.20211402.

SHANG Li-zhi,MAO Meng-di,LI Yao-yang,et al.Clinical Observation of Suanzaoren Tang Combined with Fluoxetine in Treatment of Depression of Liver Stagnation and Blood Deficiency Accompanied by Insomnia[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(24):49-54. DOI： 10.13422/j.cnki.syfjx.20211402.

摘要

目的

观察酸枣仁汤联合氟西汀治疗肝郁血虚型抑郁症伴失眠患者的临床疗效。

方法

将120例肝郁血虚型抑郁伴失眠患者随机平均分为观察组与对照组，每组60例，对照组口服盐酸氟西汀胶囊（百忧解），观察组用酸枣仁汤联合盐酸氟西汀，两组疗程均为8周。用汉密尔顿抑郁量表（HAMD），日常生活能力量表（ADL）和匹兹堡睡眠质量指数量表（PSQI）评估临床疗效；ELISA法测定血浆中5-羟色胺（5-HT），去甲肾上腺素（NE），脑源性神经营养因子（BDNF），胶质细胞源性神经营养因子（GDNF），神经元特异性烯醇化酶（NSE）和S100

水平。

结果

治疗8周后，与同组治疗前比较，观察组的HAMD和PSQI评分均显著下降（

0.01）；ADL显著提高（

0.01）；血浆5-HT，NE，GDNF和BDNF均显著增高（

0.01）。治疗后，与对照组比较，观察组总有效率显著升高（

0.01），HAMD评分和PSQI均显著降低（

0.01），ADL评分显著升高（

0.01）；血浆5-HT，NE，BDNF和GDNF水平均显著增高（

0.01），而NSE和S100

水平均显著降低（

0.01）。

结论

酸枣仁汤联合氟西汀治疗肝郁血虚型抑郁症伴失眠的疗效优于单用氟西汀。其机制可能酸枣仁汤对氟西汀增加单胺类神经递质有协同作用，并与促进BDNF和GDNF的分泌，增加对神经细胞的保护有关。

Abstract

Objective

To observe the clinical therapeutic effect of Suanzaoren Tang combined with fluoxetine in the treatment of patients with depression of liver stagnation and blood deficiency accompanied by insomnia.

Method

The patients with depression of liver stagnation and blood deficiency accompanied by insomnia （120 cases） were randomly divided into an observation group and a control group， with 60 cases in each group. The patients in the observation group received Suanzaoren Tang combined with fluoxetine， and those in the control group received fluoxetine. The course of treatment was eight weeks. The clinical efficacy was evaluated with Hamilton Depression Rating Scale （HAMD）， Pittsburgh Sleep Quality Index（PSQI）， and Activities of Daily Living （ADL） score. Enzyme-linked immunosorbent assay （ELISA） was used to determine the plasma levels of 5-hydroxytryptamine （5-HT）， norepinephrine （NE），brain-derived neurotrophic factor （BDNF）， glial cell-derived neurotrophic factor （GDNF）， neuron-specific enolase （NSE）， and S100

Result

After eight weeks of treatment， the scores of HAMD and PSQI were reduced（

0.01）， while the scores of ADL were elevated（

0.01），and the levels of 5-HT， NE， GDNF and BDNF were up-regulated （

0.01） in the plasma of patients in the observation group as compared with those before treatment. After treatment， compared with the control group， the observation group showed increased total effective rate（

0.01）， decreased scores of HAMD and PSQI （

0.01）， elevated score of ADL（

0.01）， up-regulated levels of 5-HT， NE， GDNF and BDNF in plasma， and declining NSE and S100

（

0.01）.

Conclusion

Suanzaoren Tang combined with fluoxetine is superior to fluoxetine alone in treating the depression of liver stagnation and blood deficiency accompanied by insomnia. Its therapeutic effect is achieved by increasing the release of monoamine neurotransmitters and promoting the secretion of BDNF and GDNF in the brain.

关键词

抑郁症失眠酸枣仁汤去甲肾上腺素（NE）5-羟色胺（5-HT）脑源性神经营养因子（BDNF）

Keywords

depressioninsomniaSuanzaoren Tangnorepinephrine（NE）5-hydroxytryptamine（5-HT）brain-derived neurotrophic factor （BDNF）

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