Effects of Shugan Jieyu capsule combined with mirtazapine on mental state and cancer-related fatigue in patients with liver cancer and depression

Lu Ruijuan; Zhang Pan; Zhang Ke

doi:10.3969/j.issn.1672-8157.2025.05.007

Abstract：Objective To investigate the effects of Shugan Jieyu capsule combined with mirtazapine on mental state and can-cer-induced fatigue in patients with liver cancer and depression.Methods A total of 154 patients with liver cancer and depression admitted to Puyang People's Hospital from December 2021 to February 2024 were divided into the combined group and mirtazapine group by using random number table method,with 77 in each group.The patients in the combined group were given Shugan Jieyu capsule combined with mirtazapine while those in the mirtazapine group only received mirtazapine.The treatment continued for 4 weeks in both groups.The hospital anxiety and depression scale(HADS)and Piper revised fatigue scale(PFS-R)were used to evaluate the patients'mental state and cancer-related fatigue symptoms.The levels of inflammatory factors and neurotransmitters be-fore and after treatment were compared between the two groups.Results After treatment,the depression,anxiety and total score of HADS in the combined group((6.83±1.80)points,(6.29±2.87)points,(13.12±2.85)points)were lower than those in the mirtazapine group((10.84±1.93)points,(9.78±1.95)points,(20.62±3.03)points,respectively),and the differences were statistically significant(all P<0.05).The behavioral dimension,emotional dimension,physical dimension,cognitive dimension and total score of PFS-R scale in the combined group((2.47±0.98)points,(2.58±0.88)points,(2.93±0.73)points,(2.84±0.94)points,(2.39±1.08)points)were lower than those in the mirtazapine group((5.36±1.83)points,(5.83±1.33)points,(5.27±1.65)points,(5.72±1.67)points,(5.93±1.54)points,respectively),and the differences were statistically significant(all P<0.05).The levels of hypersensitive C-reactive protein,tumor necrosis factor-α and interleukin-1β were(3.18±1.67)mg·L-1,(12.71±5.93)pg·mL-1,(8.13±4.90)pg·mL-1 in the com-bined group and they were lower than those of(7.89±2.81)mg·L-1,(16.48±6.78)pg·mL-1,(14.88±5.34)pg·mL-1 in the mirtazapine group.The levels of serotonin,norepinephrine and dopamine((148.23±25.64)μg·L-1,(43.13±9.83)ng·mL-1,(4.64±1.56)μmol·L-1)in the combined group were higher than those in the mirtazapine group((84.43±27.12)μg·L-1,(27.16±12.45)ng·mL-1,(2.88±1.49)μmol·L-1),and the differences were statistically significant(all P<0.05).Conclusion Shugan Jieyu capsule combined with mirtazapine can effectively improve psychological symptoms and alleviate cancer-induced fatigue in patients with liver cancer and depression,and the mechanism of which may be related to inhibiting inflammation and regulating neurotransmitters.