目的 探讨乌灵胶囊联合氟伏沙明治疗抑郁症的临床疗效。方法 选取2023年3月—2023年8月北京市怀柔安佳医院门诊收治的97例抑郁症患者，按随机数字表法分为对照组（48例）和治疗组（49例）。对照组睡前口服马来酸氟伏沙明片，100 mg/次，1次/d。治疗组在对照组治疗基础上口服乌灵胶囊，3粒/次，3次/d。两组疗程均为6周。观察两组的临床疗效，比较各时间点（即治疗前和治疗2、4、6周）17项汉密尔顿抑郁量表（HAMD-17）评分及治疗前后9项患者健康问卷（PHQ-9）、阿森斯失眠量表（AIS）等量表评分和血清脑源性神经营养因子（BDNF）、白细胞介素-18（IL-18）、细胞间黏附分子-1（ICAM-1）等指标水平。结果 治疗后，治疗组患者总有效率是95.92%，显著高于对照组的81.25%（P＜0.05）。治疗2、4、6周，两组HAMD-17评分都小于同组治疗前（P＜0.05）；治疗2、4、6周治疗组HAMD-17评分小于对照组同期（P＜0.05）。治疗后，两组PHQ-9、DASS-21、AIS评分都小于同组治疗前，而SF-36评分高于治疗前（P＜0.05）；治疗后，治疗组PHQ-9、DASS-21、AIS、SF-36评分改善情况优于对照组（P＜0.05）。治疗后，两组血清BDNF水平都显著上升，血清IL-18、ICAM-1水平显著降低（P＜0.05）；治疗后，治疗组患者血清BDNF、IL-18、ICAM-1水平改善优于对照组（P＜0.05）。结论 乌灵胶囊联合氟伏沙明能有效提高抑郁症患者的临床疗效，降低机体炎症反应与神经元功能损伤，促进抑郁、焦虑等不良情绪体验缓解，改善睡眠情况和生活质量。

Objective To explore the clinical efficacy of Wuling Capsules combined with fluvoxamine in treatment of depression. Methods A total of 97 patients with depression admitted to the Outpatient Department of Beijing Huairou Anjia Hospital from March 2023 to August 2023 were selected and divided into control group (48 cases) and treatment group (49 cases) according to random number table method. Patients in the control group were po administered with Fluvoxamine Maleate Tablets before going to bed, 100 mg/time, once daily. Patients in the treatment group were po administered with Wuling Capsules on the basis of the control group, 3 capsules/time, 3 times daily. The treatment course of both groups was 6 weeks. The clinical efficacy of the two groups was observed. 17 Hamilton Depression Scale (HAMD-17) scores at each time point (before treatment and 2, 4, and 6 weeks after treatment), 9 Patient Health Questionnaire (PHQ-9) and Asens Insomnia Scale (AIS) scores, serum levels of brain-derived neurotrophic factor (BDNF), Interleukin-18 (IL-18), and intercellular adhesion molecule-1 (ICAM-1) in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 95.92%, which was significantly higher than that of the control group (81.25%, P < 0.05). After 2, 4 and 6 weeks of treatment, HAMD-17 scores in both groups were lower than before treatment (P < 0.05). The HAMD-17 score of the treatment group was lower than that of the control group after 2, 4 and 6 weeks of treatment (P < 0.05). After treatment, PHQ-9, DASS-21 and AIS scores in both groups were lower than before, but SF-36 scores were higher than before (P < 0.05). After treatment: the improvement of PHQ-9, DASS-21, AIS and SF-36 scores in the treatment group was better than that in the control group (P < 0.05). After treatment, serum BDNF levels were significantly increased in both groups, but serum IL-18 and ICAM-1 levels were significantly decreased (P < 0.05). After treatment, the serum levels of BDNF, IL-18 and ICAM-1 in the treatment group were better than those in the control group (P < 0.05). Conclusion Wuling Capsules combined with fluvoxamine can effectively improve the clinical efficacy of patients with depression, reduce inflammation and neuronal function damage, promote depression, anxiety and other adverse emotional experience relief, which can improve sleep and quality of life.

R971

北京怀柔安佳医院科学技术研究与开发项目(BF-2022-36)