目的 探讨圣·约翰草提取物片联合艾司西酞普兰治疗抑郁症的临床疗效。方法 纳入2021年1月—2024年7月厦门市仙岳医院收治的116例抑郁症患者的病例资料，进行回顾性分析研究，按治疗方案不同分为对照组和治疗组，每组各58例。对照组口服草酸艾司西酞普兰片，初始剂量10 mg/d，晨间餐后顿服；根据患者耐受性及疗效，7 d后可调整至20 mg/d。治疗组以对照组用药为基础，加用圣∙约翰草提取物片口服治疗，1片/次，3次/d，用药期间需避免强光直射皮肤。两组疗程8周。观察两组临床疗效和治疗前和治疗第2、4、6、8周17项汉密尔顿抑郁量表（HAMD-17）动态评分。比较治疗前后相关评分[Young躁狂评定量表（YMRS）、失眠严重程度指数（ISI）、90项症状自评量表（SCL-90）、36项健康调查简表（SF-36）]、中性粒细胞与淋巴细胞比值（NLR）、系统免疫炎症指数（SII）和血清白细胞介素-6（IL-6）水平。结果 治疗组总有效率是94.83%，显著高于对照组的82.76%（P＜0.05）。治疗后（第2、4、6、8周）HAMD-17动态评分显示，两组均较同组治疗前显著降低（P＜0.05）；治疗组均低于对照组同期（P＜0.05）。治疗后，相关评分显示，两组YMRS、ISI、SCL-90评分降低，而SF-36评分增加（P＜0.05）；且治疗后，治疗组评分变化幅度更显著（P＜0.05）。治疗后炎症指标显示，两组NLR、SII和血清IL-6水平下降（P＜0.05）；且治疗组降低幅度更显著（P＜0.05）。结论 圣∙约翰草提取物片联合艾司西酞普兰治疗抑郁症能进一步增强抗抑郁效果，减轻患者机体炎症损害，促进患者情绪症状、睡眠障碍好转，利于其身心健康恢复，值得临床推广应用。

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

厦门市卫生健康高质量发展科技计划项目（2024GZL-GG93）