疏肝和胃方治疗肿瘤相关性抑郁临床研究

王海明，李绍旦，王茂云

中国人民解放军总医院，北京 100853

摘要：目的 观察疏肝和胃方治疗肿瘤相关性抑郁的临床疗效。方法 将 92例患者随机分为对照组和治疗组各 46 例。2组患者均已完成肿瘤针对性治疗（如放疗、化疗），病情处于稳定阶段。对照组予盐酸氟西汀分散片，每次20 mg，每日 1次，口服；治疗组予疏肝和胃方，每日1剂，每日2次，口服。均治疗6周。观察 2组治疗前后汉密顿抑郁量表（HAMD）评分、卡氏评分（KPS），检测脑内神经递质去甲肾上腺素（NE）、

5-羟色胺（5-HT）水平，血清白细胞介素-6（IL-6）及肿瘤坏死因子（TNF）-α 含量，并进行安全监测。结果 与本组治疗前比较，2 组治疗后 HAMD 评分明显降低（P＜0.01)；治疗后治疗组 HAMD 评分低于

对照组（P＜0.01）。治疗组治疗后 KPS 较治疗前升高，且优于对照组（P＜0.05）。与本组治疗前比较，2 组治疗后脑内 NE、5-HT 水平升高，IL-6、TNF-α 水平降低（P＜0.05)。治疗后治疗组脑内 NE、5-HT 水平高于

对照组，IL-6、TNF-α 水平低于对照组（P＜0.05，P＜0.01）。治疗组未见不良事件，对照组轻度恶心5例、肝功能异常6例。结论 疏肝和胃方可提高肿瘤相关性抑郁患者脑内NE、5-HT水平，降低细胞因子水平，改善肿瘤患者抑郁状态。

关键词：恶性肿瘤；疏肝和胃方；抑郁；神经递质

DOI：10.3969/j.issn.1005-5304.2017.11.006

中图分类号：R273；R277.794 文献标识码：A

Clinical Study on Shugan Hewei

文章编号：1005-5304(2017)11-0022-04

Formula for Treatment of Cancer-related Depression

WANG Hai-ming, LI Shao-dan, WANG Mao-yun (Chinese PLA General Hospital, Beijing 100853, China)

Abstract: Objective To observe the clinical efficacy of Shugan Hewei Formula for cancer-related depression. Methods Totally 92 cancer-related depression patients were randomly divided into two groups, with 46 patients in each group. All patients already finished the treatment such as radiotherapy and chemotherapy, and were in stable stage. The Fluoxetine Hydrochloride Dispersible Tablets was given to the patients in the control group, 20 mg each time, once a day, orally; Shugan Hewei Formula was given to those in the treatment group, a dose a day, twice a day, orally. The treatment for both groups lasted for 6 weeks. Before and after treatment, HAMD scores and KPS scores were observed; the change of cerebral neurotransmitters levels in the brain of patients were detected; IL-6 and TNF-α in serum were tested by ELISA. Results HAMD scores in the two groups decreased markedly after treatment

(P<0.05). HAMD scores in treatment group was less than that in control group after treatment (P<0.05). KPS scores increased in treatment group after treatment, and were better than the control group (P<0.05). The contents of NE,

5-HT increased, IL-6 and TNF-αdecreased in both groups after treatment (P<0.05). The contents of NE and 5-HT in the treatment group were higher than the control group after treatment, while the contents of IL-6 and TNF-α were lower than the control group (P<0.05, P<0.01). No adverse reactions and side effects were observed in the treatment group. 5 cases of mild nausea and 6 cases of abnormal liver function were found in the control group. Conclusion Shugan Hewei Formula can increase the contents of NE and 5-HT in the brain of cancer-related depression patients, decreased cytokines levels, and improve patients’ depressive state.

Key words: cancer; Shugan Hewei Formula; depression; cerebral neurotransmitters 肿瘤相关性抑郁（cancer-related depression）是恶

基金项目：解放军总医院科研扶持基金（2016FC-TSYS-2015）

通讯作者：李绍旦，E-mail：Lsd301@126.com 性肿瘤患者最常见的情绪障碍，有资料显示，我国发病率约 25.8%～58%[1]，明显高于正常人群中抑郁症的发病率（18.37%）[2]。本病可明显降低患者生活质量，也是导致肿瘤发生、发展、复发、转移及增加死