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目的:观察安神解郁方治疗2型糖尿病合并抑郁症的临床疗效。方法:以Zung氏抑郁量表(SDS)筛选出127例糖尿病合并抑郁症患者,随机分为治疗组64例,对照组63例。在常规降糖治疗基础上治疗组采用安神解郁方口服,对照组采用奥氮平片口服。2组疗程均为8周。观察汉密顿抑郁量表(HAMD)评分、中医证候积分、空腹血糖、糖化血红蛋白(HbA1c)等指标。结果:2组于治疗后第4、8周HAMD评分均较治疗前降低(P<0.01);第8周治疗组HAMD评分低于对照组(P<0.01)。2组于治疗后第4、8周中医证候积分均较治疗前降低(P<0.01);第8周治疗组中医证候积分低于对照组(P<0.01)。2组于治疗后第4、8周空腹血糖水平均较治疗前降低(P<0.01);第8周治疗组空腹血糖水平低于对照组(P<0.05)。2组于治疗后第4、8周HbA1c均较治疗前降低(P<0.01);第8周治疗组HbA1c低于对照组(P<0.01)。治疗组未见明显不良反应发生。对照组出现7例不良反应,均为轻中度,经对症处理后消失。结论:安神解郁方对2型糖尿病合并抑郁症有确切的临床疗效,且副反应少,值得进一步研究。
Objective: To observe the therapeutic effect of Anshen Jieyu Decoction on type 2 diabetes with depression. Methods: A total of 127 patients with diabetes mellitus and depression were screened by Zung’s Depression Scale (SDS). They were randomly divided into treatment group (64 cases) and control group (63 cases). On the basis of routine hypoglycemic treatment, the treatment group was given Anshen Jieyu Decoction, and the control group was orally taken olanzapine tablets. The two groups were treated for 8 weeks. HAMD score, TCM syndrome score, fasting blood glucose, glycosylated hemoglobin (HbA1c) and other indicators were observed. Results: The HAMD scores of the two groups were lower than those before treatment at the 4th and 8th week after treatment (P <0.01). The HAMD score of the 8th week group was lower than that of the control group (P <0.01). The scores of TCM syndromes in both groups were lower than those before treatment in the 4th and 8th week after treatment (P <0.01). The scores of TCM syndromes in the 8th week in the treatment group were lower than those in the control group (P <0.01). The fasting blood glucose levels in both groups were lower than those before treatment at the 4th and 8th week after treatment (P <0.01). The fasting blood glucose level in the 8th week group was lower than that of the control group (P <0.05). The levels of HbA1c in both groups were lower than those before treatment (P <0.01) at the 4th and 8th week after treatment. HbA1c in the 8th week was lower than that of the control group (P <0.01). No significant adverse reactions occurred in the treatment group. There were 7 adverse reactions in the control group, both mild and moderate, and disappeared after symptomatic treatment. Conclusion: Anshen Jieyu Decoction has definite clinical curative effect on type 2 diabetes mellitus with depression and less side effects, which deserves further study.