目的 探讨巴戟天寡糖胶囊联合舍曲林治疗产后抑郁症的临床效果。方法 选取2018年10月—2021年10月在巴彦淖尔市中医医院治疗的120例产后抑郁症患者。随机分为对照组和治疗组，每组各60例。对照组口服盐酸舍曲林片，50 mg/次，1次/d。在此基础上，治疗组口服巴戟天寡糖胶囊，1粒/次，2次/d。两组患者连续治疗6周。观察两组患者临床疗效，比较治疗前后两组患者爱丁堡产后抑郁量表（EPDS）总分、24项汉密尔顿抑郁量表（HAMD-24）评分、阿森斯失眠量表（AIS）评分、36项健康调查简表（SF-36）总分，及血清雌二醇（E₂）、皮质醇（COR）、多巴胺（DA）、5-羟色胺（5-HT）、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平。结果 治疗后，治疗组临床有效率为95.00%，显著高于对照组的81.67%（P＜0.05）。治疗2、4、6周时，两组EPDS总分和HAMD-24评分均显著低于治疗前（P＜0.05），且与同期对照组相比，治疗组EPDS总分和HAMD-24评分均显著更低（P＜0.05）。与治疗前相比，两组治疗后AIS评分均显著降低，SF-36总分则均显著升高（P＜0.05），且均以治疗组的改善更显著（P＜0.05）。治疗后，两组血清E₂、DA和5-HT水平均显著升高，血清COR、TNF-α和IL-6水平均显著下降（P＜0.05），且治疗后治疗组血清E₂、DA、5-HT、COR、TNF-α和IL-6水平明显好于对照组（P＜0.05）。结论 巴戟天寡糖胶囊联合舍曲林治疗产后抑郁症的效果确切，是控制患者抑郁样症状、改善睡眠质量及提高生活质量的安全有效途径，并能进一步纠正患者神经内分泌紊乱及下丘脑–垂体–肾上腺皮质（HPA）轴功能异常、抑制体内炎症反应。

Objective To investigate the clinical effect of Bajitian Guatang Capsules Combined with sertraline in treatment of postpartum depression. Methods Patients (120 cases) with postpartum depression in Bayannur Chinese Medicine Hospital from October 2018 to October 2021 were randomly divided into control and treatment group, and each group had 60 cases. Patients in the control group were po administered with Sertraline Hydrochloride Tablets, 50 mg/time, once daily. Patients in the treatment group were po administered with Bajitian Guatang Capsules on the basis of the control group, 1 grain/time, twice daily. Patients in two groups were treated for 6 weeks. After treatment, the clinical evaluation was evaluated, the score of EPDS, HAMD-24, AIS, SF-36, and the levels of E₂, COR, DA, 5-HT, TNF-α, and IL-6 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 95.00%, which was significantly higher than that of the control group (81.67%) (P < 0.05). At 2, 4 and 6 weeks after treatment, the total score of EPDS and the score of HAMD-24 in two groups were significantly lower than those before treatment, and these scores in the treatment group were significantly lower than those in the control group (P < 0.05). Compared with those before treatment, the AIS score decreased significantly, and the total score of SF-36 increased significantly in two groups after treatment, and the improvement of these scores in the treatment group were more significant. Compared with those before treatment, the levels of serum E₂, DA and 5-HT increased significantly (P < 0.05), while the levels of serum COR, TNF-α and IL-6 decreased significantly in two groups (P < 0.05). After treatment, the levels of serum E₂, DA, 5-HT, COR, TNF-α and IL-6 in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Bajitian Guatang Capsules Combined with sertraline is effective in the treatment of postpartum depression, which is a safe and effective way to control depression-like symptoms, improve sleep quality and improve quality of life, and can further correct neuroendocrine disorders and hypothalamic-pituitary-adrenocortical (HPA) axis dysfunction and inhibit inflammation in vivo.

R971

巴彦淖尔市医院2020年院内科研课题(2020019)