加味甘麦大枣汤对气血两虚型产后抑郁症患者肠道菌群和血清5-HT的影响

观察加味甘麦大枣汤对气血两虚型产后抑郁症（PPD）患者肠道菌群和血清5-羟色胺（5-HT）水平的影响。

选取2022年10月至2023年8月就诊于甘州区妇幼保健院且符合纳入标准的气血亏虚型产后抑郁症患者60例作为研究对象，按其就诊顺序随机分为观察组、对照组，每组各30例。对照组给予西医常规治疗，观察组在西医常规治疗基础上联合加味甘麦大枣汤治疗，疗程4周。分别于治疗前和治疗后采用中医证候积分和汉密尔顿抑郁量表（HAMD）评价治疗疗效。通过高通量测序法检测两组患者治疗前后粪便中的菌群多样性和各分类学水平分布。采用酶联免疫吸附测定（ELISA）检测两组患者血清5-HT水平。

与本组治疗前比较，治疗后两组患者中医证候积分和HAMD评分均明显下降，差异具有统计学意义（P＜0.05）。治疗后，与对照组比较，观察组的中医证候积分和HAMD评分显著下降（P＜0.05）。观察组临床有效率为96.7%，高于对照组的76.7%（χ²=8.967，P=0.030）。观察组肠道菌群在治疗后的Simpson指数和Shannon指数较治疗前升高（P＜0.05），拟杆菌门（Bacteroidetes）、瘤胃菌科（Ruminococcaceae）、拟杆菌属（Bacteroides）和双歧杆菌属（Bifidobacterium）相对丰度显著高于对照组（P＜0.05），变形菌门（Proteobacteria）、肠杆菌科（Enterobacteriaceae）、粪球菌属（Coprococcus）和志贺菌属（Shigella）相对丰度显著低于对照组（P＜0.05）。两组患者血清5-HT水平治疗后均明显升高（P＜0.05），观察组5-HT水平升高的更明显（P=0.010）。

加味甘麦大枣汤可辅助临床治疗改善PPD患者的临床症状，调节患者肠道菌群，提高血清5-HT水平。

Effect of supplemented Ganmai Dazao Decoction on intestinal microbiota and serum 5-HT in postpartum depression patients with deficiency of Qi and blood

ObjectiveTo observe the effect of supplemented Ganmai Dazao Decoction on intestinal microbiota and serum 5-hydroxytryptamine (5-HT) level in postpartum depression (PPD) patients with deficiency of Qi and blood. MethodsSixty patients with PPD associatd with Qi and blood deficiency who met the inclusion criteria and were admitted to our hospital from October 2022 to August 2023 were selected as the subjects, and randomly divided into observation group and control group according to the order of treatment, with 30 cases in each group. Both groups were given conventional Western medicine treatment, while the observation group was additionally given supplemented Ganmai Dazao Decoction; the course of treatment was 4 weeks. TCM syndrome score and Hamilton Depression Scale (HAMD) were used to evaluate the efficacy before and after treatment. The diversity and taxonomic-level distribution of fecal bacteria in both groups before and after treatment were detected using high-throughput sequencing. The serum 5-HT level was detected with ELISA. ResultsCompared with before treatment, the TCM syndrome scores and HAMD scores in both groups after treatment significantly decreased (P＜0.05). After treatment, the TCM syndrome scores and HAMD scores in the observation group significantly decreased compared with the control group (P＜0.05). The clinical efficiency rate in the observation group (96.7%) was higher than that in the control group (76.7%); the difference was significant (χ2=8.967, P=0.030). The Simpson index and Shannon index in the observation group were higher than those before treatment (P＜0.05). After treatment, the relative abundances of Bacteroidetes, Ruminococcaceae, Bacteroides and Bifidobacterium in the observation group significantly increased compared with the control group (P＜0.05), while those of Proteobacteria, Enterobacteriaceae, Coprococcus and Shigella significantly decreased (P＜0.05). The serum 5-HT concentration in both groups after treatment significantly increased (P＜0.05). Compared with the control group, the 5-HT concentration in the observation group after treatment significantly increased (P=0.010). ConclusionSupplemented Ganmai Dazao Decoction can be an adjunct to clinical treatment to improve the clinical symptoms of PPD patients, regulate the intestinal microbiota of patients, and increase the level of serum 5-HT.