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非发酵型益生菌联合巴戟天寡糖治疗伴有胃肠道症状的重度抑郁症的疗效和安全性:一项随机、双盲、对照临床试验

 

Authors Zhou J, Wang X, Wang R, Deng Y, Lyu N, Li R, Li X, Liu J, Yang J, Zhou J, Wang G

Received 27 May 2025

Accepted for publication 18 September 2025

Published 30 September 2025 Volume 2025:21 Pages 2251—2264

DOI https://doi.org/10.2147/NDT.S534858

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Yu-Ping Ning

Jingjing Zhou,1,2,* Xiao Wang,1,2,* Ran Wang,3,* Yannan Deng,1,2 Nan Lyu,1,2 Ruinan Li,1,2 Xiaoya Li,1,2 Jing Liu,1,2 Jian Yang,1,2 Jia Zhou,1,2 Gang Wang1,2 

1The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China; 3Key Laboratory of Functional Dairy, Department of Nutrition and Health, China Agricultural University, Beijing, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jia Zhou, The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, People’s Republic of China, Tel +86 10 58340322, Email sophie_2020@ccmu.edu.cn Jian Yang, The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, People’s Republic of China, Tel +86 10 58340278, Email yangjian@ccmu.edu.cn

Objective: This study aimed to evaluate the clinical efficacy and safety of Morinda officinalis oligosaccharides (MOO) combined with probiotics compared to placebo in individuals diagnosed with major depressive disorder (MDD) who also presented with gastrointestinal symptoms, a common comorbidity in this population.
Methods: In an 8-week, randomized, double-blind, placebo-controlled trial conducted at Beijing Anding Hospital, 108 patients meeting DSM-5 criteria for MDD were recruited. Participants were randomly assigned to receive either MOO (2 capsules BID) plus probiotics (Lacticaseibacillus paracasei L9, Bifidobacterium animalis subsp. lactis A6, Bifidobacterium bifidum B09, and Lactiplantibacillus plantarum LP06) or MOO plus placebo. The primary outcome was the change in HAMD-17 (17-item Hamilton Rating Scale for Depression) scores from baseline to Week 8. Both intention-to-treat (ITT) and per-protocol (PP) analyses were conducted.
Results: The ITT analysis revealed no significant difference in total HAMD-17 score reduction between groups (Z = 0.02, p = 0.983). However, the group receiving MOO plus probiotics demonstrated a significantly greater reduction in insomnia-related symptoms at Week 2 (Z = − 2.23, p = 0.028). Although the overall depression severity did not differ, early response (Week 2) and response rates in the probiotics group were 35.19% and 51.85%, respectively, without significant group differences. Logistic regression suggested that female patients and those with a family history of psychiatric disorders were less likely to respond to treatment. Adverse events were mild, mainly gastrointestinal (eg, diarrhea, constipation), and occurred at the same rate (5.56%) in both groups.
Conclusion: Although MOO combined with probiotics did not significantly improve overall depressive symptoms compared to placebo, it showed early and specific benefits for insomnia symptoms. The intervention was safe and well tolerated. These findings highlight the potential role of gut microbiota modulation in treating MDD-related symptoms and suggest further research is needed to explore underlying mechanisms and identify responsive subgroups.
Trial Registration: The study was prospectively registered with the Chinese Clinical Trial Registry (ChiCTR2200055780; https://www.chictr.org.cn/showproj.html?proj=150742) on January 19, 2022.

Keywords: major depressive disorder, probiotics, morinda officinalis oligosaccharides, gastrointestinal, efficacy