逍遥归脾汤联合米氮平治疗恶劣心境40例

目的 观察中西医结合疗法治疗恶劣心境的临床疗效。方法 将80例恶劣心境（肝郁脾虚证）患者分为治疗组（逍遥归脾汤联合米氮平治疗）和对照组（单用米氮平治疗），每组40例。治疗前及治疗第4周和第8周末，分别观察两组抑郁自评量表（self-rating depression scale，SDS）和汉密尔顿抑郁量表（Hamilton depression scale，HAMD）评分；治疗第8周末，观察并比较两组中医症状疗效和西医临床疗效。结果 治疗第4周和第8周末，两组SDS和HAMD评分均较治疗前显著降低（P＜0.01）；治疗第8周末，治疗组SDS和HAMD评分下降值显著大于对照组（P＜0.05，或P＜0.01）。治疗组在中医症状（包括精神抑郁、胸胁作胀、胸闷心悸、脘痞纳呆、善太息、月经不调、脉弦细）总有效率及西医临床总有效率方面显著优于对照组（P＜0.05，或P＜0.01）。结论 逍遥归脾汤联合米氮平治疗恶劣心境（肝郁脾虚证）的疗效优于单用米氮平。

Clinical Efficacy of Xiaoyao Guipi Decoction Combined with Mirtazapine in Treatment of Dysthymic Disorder: A Report of 40 Cases

Objective To observe the clinical efficacy of integrated traditional Chinese and Western medicine therapy for dysthymic disorder. Methods Eighty patients with dysthymic disorder (syndrome of stagnation of liver qi and spleen deficiency) were divided into treatment group (n=40) and control group (n=40). The treatment group received Xiaoyao Guipi Decoction combined with mirtazapine, while the control group received mirtazapine alone. Before and at the ends of weeks 4 and 8 of treatment, Self-Rating Depression Scale (SDS) and Hamilton Depression Scale (HAMD) scores were determined. At the end of week 8, the treatment outcomes were evaluated and compared in terms of improvements in traditional Chinese medicine (TCM) and Western medicine (WM) symptoms. Results At the ends of weeks 4 and 8, both groups showed significant decreases in SDS and HAMD scores (P<0.01). At the end of week 8, the treatment group had significantly higher decreases in SDS and HAMD scores than the control group (P<0.05 or P<0.01). Compared with the control group, the treatment group had significantly higher overall response rates in terms of TCM symptoms (mental depression, chest distress, chest discomfort and palpitation, epigastric oppression and poor appetite, susceptible sigh, irregular menstruation, and fine and string-like pulse) and WM symptoms (P<0.05 or P<0.01). Conclusion Xiaoyao Guipi Decoction combined with mirtazapine has better clinical efficacy than mirtazapine alone in the treatment of dysthymic disorder (syndrome of stagnation of liver qi and spleen deficiency).