目的 探讨舒眠胶囊联合曲唑酮治疗老年抑郁症的临床疗效。方法 选取2023年2月—2024年6月河北省第三荣军优抚医院收治的84例老年抑郁症患者，按随机数字表法分为对照组和治疗组，每组各42例。对照组睡前口服盐酸曲唑酮片，起始剂量100 mg/次，1次/d，服用3 d后增加50 mg/次。治疗组在对照组治疗基础上晚饭后、临睡前口服舒眠胶囊，3粒/次，2次/d。两组疗程6周。观察两组临床疗效，比较两组治疗前、治疗2、4、6周17项汉密尔顿抑郁量表（HAMD-17）评分及治疗前后中医症状总积分、老年抑郁症状问卷（GDI）、简式抑郁-焦虑-压力量表（DASS-21）和睡眠状况自评量表（SRSS）评分，中性粒细胞与淋巴细胞比值（NLR）、红细胞分布宽度（RDW）和血清C反应蛋白（CRP）水平变化。结果 治疗组总有效率是95.24%，显著高于对照组的80.95%（P＜0.05）。治疗2、4、6周两组HAMD-17评分均明显低于治疗前（P＜0.05）；治疗后各时点，治疗组HAMD-17评分均低于对照组同期（P＜0.05）。治疗后，两组中医症状总积分和GDI、DASS-21、SRSS评分低于组内治疗前（P＜0.05）；治疗后，治疗组中医症状总积分和GDI、DASS-21、SRSS评分低于对照组（P＜0.05）。治疗后，两组NLR、RDW和血清CRP水平均显著下降（P＜0.05），且治疗后治疗组NLR、RDW和血清CRP水平均低于对照组（P＜0.05）。结论 舒眠胶囊联合曲唑酮治疗老年抑郁症能有效减轻抑郁症状及伴随的临床表现，促进情绪状态、睡眠状况及生活质量好转，且利于机体炎症反应进一步控制，整体疗效较佳，值得临床推广应用。

Objective To explore the clinical efficacy of Shumian Capsules combined with trazodone in treatment of senile depression. Methods A total of 84 patients with senile depression admitted to Hebei Province Third Military Special Care Hospital from February 2023 to June 2024 were selected and divided into control group and treatment group according to random number table method, with 42 cases in each group. Patients in control group were po administered with Trazodone Hydrochloride Tablets before going to bed, the initial dose was 100 mg/time, once daily, and 50 mg/time was increased after 3 d of administration. Patients in treatment group were po administered with Shumian Capsules after dinner and before going to bed on basis of control group, 3 capsules/time, twice daily. Both groups were treated for 6 weeks. The clinical efficacy of two groups was observed, and 17 Hamilton Depression Scale (HAMD-17) scores were compared between two groups before treatment, and 2, 4 and 6 weeks of treatment. The scores of total Chinese medicine symptom score, senile depressive Symptom Questionnaire (GDI), simplified depression-Anxiety-Stress Scale (DASS-21), Sleep status Self-rating Scale (SRSS), neutrophil to lymphocyte ratio (NLR), red blood cell distribution width (RDW), and serum C-reactive protein (CRP) in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 95.24%, which was significantly higher than that of the control group (80.95%, P < 0.05). HAMD-17 scores in 2, 4 and 6 weeks of treatment were significantly lower than before treatment (P < 0.05). HAMD-17 scores in treatment group were lower than those in control group at all time points after treatment (P < 0.05). After treatment, the total score of TCM symptoms, the scores of GDI, DASS-21, and SRSS in two groups were lower than before treatment (P < 0.05). After treatment, the total TCM symptom score, GDI, DASS-21, and SRSS scores in treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of NLR, RDW, and serum CRP in both groups were significantly decreased (P < 0.05), and the levels of NLR, RDW, and serum CRP in treatment group were lower than those in control group (P < 0.05). Conclusion Shumian Capsules combined with trazodone in treatment of senile depression can effectively reduce depressive symptoms and accompanying clinical manifestations, and can promote the improvement of emotional state, sleep status and life quality, and further control the inflammatory response of the body, the overall effect is good, which is worthy of clinical promotion and application.

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