标题：珍珠养心安神汤对创伤后应激障碍患者HAMD和PTSD-SS评分及细胞因子和相关代谢产物的影响

      作者：郭骏成 1，陈荣 2，郭敏 3，郑进方 3，符林梅 3，李庆忠 4    (1.南华大学研究生院，湖南 衡阳 421000；2.海口市中医医院护理部，海南 海口 570203；3.海南省人民医院科教处，海南 海口 570311；4.海口市妇幼保健院儿科，海南 海口 570203)

      卷次： 2017年28卷13期

      【摘要】 目的 观察珍珠养心安神汤对创伤后应激障碍(PTSD)患者的汉密尔顿抑郁量表(HAMD)和创伤后应激障碍自评量表(PTSD-SS)评分及细胞因子和相关代谢产物的影响。方法 选取 2015年 6至 2016年 5月在海南省两家医院中医门诊就诊且年龄在 30~60岁的 55例PTSD患者，采用完全随机分组方法分为观察组 28例和对照组 27例，两组患者均给予口服盐酸帕罗西汀片及心理疗法等综合治疗 3个月，观察组再加服自拟中药珍珠养心安神汤。比较两组患者治疗前后的HAMD和 PTSS评分及不同时间点细胞因子和相关代谢产物的变化情况。结果 治疗前对照组和观察组两组患者PTSD-SS评分为(63.24±6.16)分、(65.64±7.02)分，HAMD得分为(30.24±2.05)分、(29.28±1.97)分，治疗前两组患者PTSD-SS评分和HAMD得分比较差异均无统计学意义(P>0.05)；治疗后对照组和观察组两组患者 PTSD-SS评分为(31.40±4.29)分、(28.32±4.18)分，HAMD得分为(13.08±2.30)分、(11.72±2.13)分，治疗后两组患者PTSD-SS评分和HAMD得分比较差异均有统计学意义(P<0.05)。两组患者随着治疗时间的延长血浆白介素2 (IL-2)、白介素6 (IL-6)、白介素8 (IL-8)、血清丙二醛(MDA)、去甲肾上腺素(NE)、一氧化氮(NO)、人血管活性肠肽(VIP)含量均呈逐渐降低的趋势(P<0.05)，且观察组患者降低水平均高于对照组。两组患者促肾上腺皮质激素(ACTH)和超氧化物歧化酶(SOD)含量随着治疗时间的延长呈逐渐升高的趋势(P<0.05)。结论 珍珠养心安神汤可改善创伤后应激障碍的患者PTSD症状，对PTSD患者的细胞因子及相关代谢产物变化有一定的影响。
      【关键词】 创伤后应激障碍；心理干预；血清学检测
      【中图分类号】 R749.2 【文献标识码】 A 【文章编号】 1003—6350（2017）13—2076—04

Effect of pearl Yangxin Anshen Decoction on HAMD and PTSD-SS scores and changes of cytokines and relatedmetabolites in patients with posttraumatic stress disorder.
GUO Jun-cheng 1, CHEN Rong 2, GUO Min 3, ZHENJin-fang 3, FU Lin-mei 3, LI Qing-zhong 4. 1. Graduate School, South China University, Hengyang 421000, Hunan, CHINA;2. Department of Nursing, Haikou Hospital of Traditional Chinese Medicine, Haikou 570203, Hainan, CHINA; 3. Departmentof Science and Education, Hainan General Hospital, Haikou 570311, Hainan, CHINA; 4. Department of Pediatrics, HaikouWomen and Children Hospital, Haikou 570203, Hainan, CHINA
【Abstract】 Objective To observe the effect of pearl Yangxin Anshen Decoction on Hamilton Rating Scale forDepression (HAMD) and posttraumatic stress disorder self-rating scale (PTSD-SS) scores and changes of cytokines andrelated metabolites in patients with posttraumatic stress disorder (PTSD). Methods A total of 55 patients with PTSDaged 30-60, who admitted to outpatient clinic of two hospitals of Traditional Chinese Medicine from June 2015 to May2016, were selected and divided into the treatment group (n=28) and the control group (n=27) according to random-num-ber table. The two groups were given oral administration of paroxetine hydrochloride tablets and psychological therapyand other comprehensive treatment for 3 months, and the treatment group was additionally treated with self-induced Chi-nese medicine pearl Yangxin Anshen Decoction. The HAMD and PTSS scores of the two groups before and after the treat-ment and the changes of cytokines and related metabolites at different time points were compared. Results Before thetreatment, the scores of PTSD-SS in the control group and the observation group were respectively (63.24±6.16) and(65.64±7.02), and the HAMD scores were (30.24±2.05) and (29.28±1.97), respectively, with no significant difference inPTSD-SS score and HAMD score between the two groups (P>0.05). After the treatment, the scores of PTSD-SS in thecontrol group and the observation group were (31.40 ± 4.29), (28.32 ± 4.18), the scores of HAMD were (13.08 ± 2.30),·论 著·doi:10.3969/j.issn.1003-6350.2017.13.003基金项目：国家自然科学基金(编号：81260209)；2014年度海南省中药现代化专项项目(编号：ZY201415)；2016年度海南自然科学基金面上项目(编号：20168337)；2014年度海口市重点科技计划项目(编号：2014-065)；