Li Hai-cong, Yang Yi-ling, Yang Xue-qing, Li Qiu-bing, Wang Yan, Zhu He, Tian Xin, Chen Xiao-guang
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016 Feb;36(2):172-8.
To study the effect of Modified Guipi Decoction (MGD) on blood pressure and quality of life (QOL) in hypertension patients complicated depression.
Totally 245 hypertension patients complicated depression were randomly assigned to the treatment group (125 cases, treated with MGD) and the control group (120 cases, treated with Sertraline). Final recruited qualified patients were 117 cases in the treatment group and 111 cases in the control group. The therapeutic course for all was 4 weeks. Changes of blood pressure, scores rated by Hamilton Depression Scale-17 (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), short-form 36 health survey questionnaire (SF-36), and Treatment Emergent Symptom Scale (TESS) were observed before and after treatment, thereby judging their efficacies.
(1) Compared with before treatment in the same group, systolic and diastolic blood pressures significantly decreased in the treatment group after 2 weeks of treatment; systolic blood pressure significantly-decreased after 2 weeks of treatment and diastolic blood pressure significantly decreased after 3 weeks of treatment in the control group (all P < 0.05, P < 0.01). Decreased valley values of systolic and diastolic blood pressures at week 2, 3, and 4 after treatment were obviously higher than those at week 1 after treatment in the two groups (P < 0.05, P < 0.01). Compared with the control group at week 4 after treatment, valley value of systolic blood pressure obviously decreased in the treatment group (P <0. 01). Decreased valley values of systolic and diastolic blood pressures in the treatment group were higher than those of the control group (P <0. 01). The success rate of target blood pressure was 60. 7% (71/117 cases) in the treatment group and 42. 3% (47/111 cases) in the control group, with statistical difference (χ² = 7.6781, P < 0.01). (2) Compared with before treatment in the same group, the score of HAMD-17 at week 2, 3, and 4 after treatment all decreased in the two groups (P < 0.01). Compared with the control group, the score of HAMD-17 at week 4 after treatment decreased more obviously in the treatment group, with higher difference in decreased value (P < 0.05). The effective rate was 79.5% (93/117) in the treatment group, higher than that in the control group [66.7% (74/111); χ² = 4.7741, P < 0.05]. (3) Compared with before treatment in the same group, the score of HAMA at week 1, 2, 3, and 4 after treatment all obviously decreased in the two groups (P <0. 05, P <0. 01). Compared with the control group, the score of HAMA at week 3 and 4 after treatment decreased more obviously in the treatment group, with higher difference in decreased value (P < 0.05, P < 0.01). (4) After 4 weeks of treatment, except physical function in the control group, SF-36 total score and the score for each factor were obviously higher in the two groups (P < 0.05, P < 0.01). MGD showed superior effect in improving physical function, physical activity, overall health, emotion activity, and health changes to that of Sertraline (P < 0.05, P < 0.01). (5) The incidence of insomnia, tremor, liability to agitation, dizziness was obviously less in the treatment group than in the control group (P < 0.05).
MGD had favorable clinical effect on hypertension patients complicated depression. Meanwhile, it also could improve their blood pressure and QOL.
研究归脾汤加味（MGD）对高血压合并抑郁症患者血压及生活质量（QOL）的影响。
将245例高血压合并抑郁症患者随机分为治疗组（125例，采用MGD治疗）和对照组（120例，采用舍曲林治疗）。最终纳入合格患者，治疗组117例，对照组111例。两组疗程均为4周。观察治疗前后血压、汉密尔顿抑郁量表17项（HAMD - 17）评分、汉密尔顿焦虑量表（HAMA）评分、36项简短健康调查问卷（SF - 36）及治疗中出现的症状量表（TESS）的变化，以此判断疗效。
（1）与同组治疗前比较，治疗组治疗2周后收缩压和舒张压显著下降；对照组治疗2周后收缩压显著下降，治疗3周后舒张压显著下降（均P < 0.05，P < 0.01）。两组治疗后第2、3、4周收缩压和舒张压的谷值下降幅度明显高于治疗后第1周（P < 0.05，P < 0.01）。治疗后第4周，与对照组比较，治疗组收缩压谷值明显下降（P < 0.01）。治疗组收缩压和舒张压的谷值下降幅度高于对照组（P < 0.01）。治疗组血压达标率为60.7%（71/117例），对照组为42.3%（47/111例），差异有统计学意义（χ² = 7.6781，P < 0.01）。（2）与同组治疗前比较，两组治疗后第2、3、4周HAMD - 17评分均下降（P < 0.01）。与对照组比较，治疗组治疗后第4周HAMD - 17评分下降更明显，下降差值更大（P < 0.05）。治疗组有效率为79.5%（93/117），高于对照组[66.7%（74/111）；χ² = 4.7741，P < 0.05]。（3）与同组治疗前比较，两组治疗后第1、2、3、4周HAMA评分均明显下降（P < 0.05，P < 0.01）。与对照组比较，治疗组治疗后第3、4周HAMA评分下降更明显，下降差值更大（P < 0.05，P < 0.01）。（4）治疗4周后，除对照组生理功能外，两组SF - 36总分及各因子评分均明显升高（P < 0.05，P < 0.01）。MGD在改善生理功能、身体活动、总体健康、情感活动及健康变化方面优于舍曲林（P < 0.05, P < 0.01）。（5）治疗组失眠、震颤、易激惹、头晕的发生率明显低于对照组（P < 0.05）。
MGD对高血压合并抑郁症患者有良好的临床疗效。同时，还能改善其血压及生活质量。
