百合地黄汤加味联合艾司西酞普兰治疗围绝经期2型糖尿病合并抑郁症的疗效及对血糖、抑郁症状的影响OA

Objective To investigate the clinical efficacy of modified Baihe Dihuang decoction combined with escitalopram in the treatment of perimenopausal type 2 diabetes mellitus(T2DM)with depressive disor-der(DD)and its effect on blood glucose and depressive symptoms.Methods A total of 112 perimenopausal patients with T2DM and DD admitted to the hospital from August 2022 to March 2024 were selected as the re-search objects,and they were divided into lily group and escitalopram group by random number table method,with 56 cases in each group.Both groups were treated with conventional treatment,the escitalopram group was treated with escitalopram,and the lily group was treated with Baihe Dihuang decoction+escitalopram.The levels of blood glucose indexes[fasting plasma glucose(FPG),average postprandial 2 h plasma glucose(2 hPG),glycosylated hemoglobin(HbA1c)],depressive symptom score and total score,serum sex hormones[follicle stimulating hormone(FSH),estradiol(E2),luteinizing hormone(LH)],clinical efficacy,and adverse reactions were compared between the two groups.Results After treatment,the levels of FPG,2 hPG,HbA1c,E2,FSH and LH in the two groups were lower than those before treatment,and the level of E2 was higher than that before treatment,and the levels of FPG,2 hPG,HbA1c,FSH and LH in the lily group were lower than those in the escitalopram group,and the level of E2 was higher than that in the escitalopram group,and the differences were statistically significant(P<0.05).After treatment,the scores of depression,guilt,suicide,insomnia in the first stage of difficulty falling asleep,insomnia in the middle stage of not deep sleep,insomnia in the end of early waking,work and interest,block,agitation,mental anxiety,somatic anxiety,gas-trointestinal symptoms,sexual symptoms,suspicious pain,weight loss,insight in Hamilton depression scale and Hamilton depression scale total score in the two groups were lower than those before treatment,and the above symptom socres and total scores in the lily group were lower than those in the escitalopram group,and the differences were statistically significant(P<0.05).The total effective rate of lily group was 94.64%,which was higher than 71.43%of escitalopram group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the lily group(5.36%)and the escitalopram group(10.71%,P>0.05).Conclusion Modified Baihe Dihuang decoction combined with escitalopram can effectively improve the blood glucose level and serum sex hormone level of perimenopausal T2DM patients with DD,reduce the depressive symptom score and total score,improve the clinical efficacy,and do not increase the incidence of adverse reactions.