卒中后抑郁的中医药研究进展
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摘要
目的探讨卒中后抑郁的中医药研究进展。方法主要通过对近5年关于中医辨证论治治疗卒中后抑郁的有关文献进行总结,从病因病机、辨证分型和治疗3个方面阐述卒中后抑郁的中医药研究进展。结果中医药治疗卒中后抑郁在临床上普遍得到共识,治疗手段灵活,中西医结合治疗卒中后抑郁能显著提高临床疗效。结论中医药治疗卒中后抑郁在临床上广泛应用,但比较缺乏客观化、标准化;中医治疗卒中后抑郁的基础研究较为困难。
Objective To study the progress of TCM syndrome differentiation and treatment of Poststroke depression(PSD). Methods This paper discusses the research progress of TCM differentiateon of symptoms and signs of TCM from three aspects: Etiology and pathogenesis, TCM syndrome differentiation, treatment. Results Traditional Chinese medicine syndrome differentiation and treatment of post stroke depression has been widely recognized in clinical practice. The combination of traditional Chinese and Western medicine in the treatment of PSD can improve the efficacy and reduce the side effects. Conclusion TCM is widely used in the treatment of post-stroke depression, but it lacks objectification and standardization. The basic research of TCM in treating post-stroke depression is more difficult.
Objective To study the progress of TCM syndrome differentiation and treatment of Poststroke depression(PSD). Methods This paper discusses the research progress of TCM differentiateon of symptoms and signs of TCM from three aspects: Etiology and pathogenesis, TCM syndrome differentiation, treatment. Results Traditional Chinese medicine syndrome differentiation and treatment of post stroke depression has been widely recognized in clinical practice. The combination of traditional Chinese and Western medicine in the treatment of PSD can improve the efficacy and reduce the side effects. Conclusion TCM is widely used in the treatment of post-stroke depression, but it lacks objectification and standardization. The basic research of TCM in treating post-stroke depression is more difficult.
引文
[1]Towfi ghi A,Ovbiagele B,El H N,et al.Pos tstroke Depression:A Scientifi c Statement for Healthca re Professionals From the American Heart Association/Am erican Stroke Association[J].Stroke,2017,48(2):e30-e43.
[2]Oosterveer D M,Mishre R R,van Oort A,et al.Depression is an independent determinant of life satisfaction early after stroke[J].J Rehabil Med,201 7,49(3):223-227.
[3]Numasawa Y,Hattori T,Ishiai S,et al.Depressive disorder may be associated with raphe nuc lei lesions in patients with brainstem infarction[J].J Aff e ct Disord,2017(213):191-198.
[4]高春岭,谭华,徐磊,等.急性缺血性脑卒中后抑郁患者相关症状与血清白细胞介素-1水平的关系[J].中国老年学杂志,201 7,37(3):625-627.
[5]王少石,周新雨,朱春燕.卒中后抑郁临床实践的中国专家共识[J].中国卒中杂志,2016,11(8):685-693.
[6]Towfi ghi A,Ovbiagele B,El H N,et al.Poststroke Depression:A Scientifi c Statement for Healthcare Professionals From the American Heart Association/American Stroke Association[J].Stroke,2 017,48(2):e30-e43.
[7]岳祥海,孙新刚,梁蔚骏,等.卒中后抑郁的流行病学研究进展[J].中华临床医师杂志(电子版),2016,10(12):1790-1794.
[8]Loh A Z,Tan J S,Zhang M W,et al.The Global Prevalence of Anxiety and Depressive Symptoms Among Caregivers of Stroke Survivors[J].J Am Med Dir Assoc,2017,18(2):111-116.
[9]陈爱丽.大剂量阿托伐他汀预防缺血性脑卒中后抑郁的可行性分析[J].中国实用神经疾病杂志,2017,20(4):114-116.
[10]吴泉.益肾疏肝汤治疗脑卒中后抑郁症72例[J].陕西中医学院学报,2013(6):55-56.
[11]胡丹,盛蕾.加味柴胡疏肝颗粒辅助治疗缺血性脑卒中后抑郁的疗效观察[J].中草药,2016,47(21):3866-3870.
[12]周曾璇,刘柏炎.脑卒中后抑郁与痰瘀理论[J].长春中医药大学学报,2015(2):221-223.
[13]杨林.论肝郁与抑郁症[J].陕西中医,2000,21(6):260-261.
[14]苏杰,吴春霞.卒中后抑郁临床诊疗[J].实用中医内科杂志,2015(4):61-62.
[15]孟毅,刘志勇,乔明亮,等.177例脑卒中后抑郁病例中医证候分布特点[J].中国中医急症,2014,23(2):260-261,297.
[16]胡艳萍,张晋吉,赵玉敏,等.通络祛痰汤联合西药治疗卒中后抑郁疗效观察[J].中国实用医药,2015(11):208-209.
[17]刘占国,王慧萍.柴胡加龙骨牡蛎汤合黛力新治疗脑卒中后抑郁30例[J].江西中医药,2015(5):39-40.
[18]任宝龙,张振帅,赵晓燕,等.归脾汤加减联合黛力新治疗脑卒中后抑郁疗效的临床观察[J].中国初级卫生保健,2015(2):110-111.
[19]郑锦英.甘麦大枣汤合酸枣仁汤加减治疗脑卒中后抑郁疗效观察[J].北京中医药,2009,28(4):291-292.
[20]周勇,龙明,冉宏.西酞普兰联合养血清脑颗粒治疗脑卒中后抑郁的临床观察[J].中国药房,2014(12):1105-1107.
[21]陈江波.舒肝解郁胶囊与帕罗西汀治疗脑卒中后抑郁临床疗效对比分析[J].中西医结合研究,2015(3):138-139,141.
[22]宋昊,马建东,陈永新,等.解郁丸联合银杏叶胶囊治疗脑卒中后抑郁症的疗效分析[J].中国中医药科技,2014,21(6):671-672.
[23]白小利,杜晓伟,张灿飞,等.乌灵胶囊治疗卒中后抑郁有效性与安全性的系统评价[J].中国循证医学杂志,2014(9):1104-1111.
[24]蒋成志,苏海林,林红旭,等.中医康复治疗脑卒中后抑郁的研究近况[J].四川中医,2014(8):171-175.
[25]刘弘文.从肝脾论治脑卒中后抑郁的临床疗效[J].中国中医药现代远程教育,2015(5):25-27.
[26]彭慧渊,叶家盛,何希俊,等.电针与氟西汀胶囊治疗脑卒中后抑郁症临床随机对照研究[J].吉林中医药,2011(10):990-992.
[27]高潇,王志婕,董施秋,等.穴位注射金丝桃素单体结合捏脊疗法治疗脑卒中后抑郁的临床观察[J].中医药信息,2015(2):102-104.
[28]邓艳莉,徒成云,刘巧,等.温和灸治疗卒中后抑郁肝气郁结证40例临床观察[J].内蒙古中医药,2014(35):94-95.
[29]蔡经宇.重复经颅磁刺激辅助治疗脑中风后抑郁症的临床研究[J].河南医学研究,2013,22(3):365-366.
[30]邹生燕,刘泓.中医辨证施护结合艾灸疗法对卒中后抑郁心脾两虚型疗效观察[J].辽宁中医药大学学报,2014(4):196-198.
[31]岳红霞.针灸联合体感音乐治疗对脑卒中后抑郁患者康复的影响[J].吉林中医药,2015,35(2):203-205.
[32]张叶青,陈眉.中药辨证施治干预脑卒中后抑郁的临床研究[J].中华中医药学刊,2012(4):808-810.
[33]俞雯雯,谢海芳,蔡伯艳.卒中后抑郁的中西医治疗探讨[J].江西中医药,2007,38(7):77-78.
[2]Oosterveer D M,Mishre R R,van Oort A,et al.Depression is an independent determinant of life satisfaction early after stroke[J].J Rehabil Med,201 7,49(3):223-227.
[3]Numasawa Y,Hattori T,Ishiai S,et al.Depressive disorder may be associated with raphe nuc lei lesions in patients with brainstem infarction[J].J Aff e ct Disord,2017(213):191-198.
[4]高春岭,谭华,徐磊,等.急性缺血性脑卒中后抑郁患者相关症状与血清白细胞介素-1水平的关系[J].中国老年学杂志,201 7,37(3):625-627.
[5]王少石,周新雨,朱春燕.卒中后抑郁临床实践的中国专家共识[J].中国卒中杂志,2016,11(8):685-693.
[6]Towfi ghi A,Ovbiagele B,El H N,et al.Poststroke Depression:A Scientifi c Statement for Healthcare Professionals From the American Heart Association/American Stroke Association[J].Stroke,2 017,48(2):e30-e43.
[7]岳祥海,孙新刚,梁蔚骏,等.卒中后抑郁的流行病学研究进展[J].中华临床医师杂志(电子版),2016,10(12):1790-1794.
[8]Loh A Z,Tan J S,Zhang M W,et al.The Global Prevalence of Anxiety and Depressive Symptoms Among Caregivers of Stroke Survivors[J].J Am Med Dir Assoc,2017,18(2):111-116.
[9]陈爱丽.大剂量阿托伐他汀预防缺血性脑卒中后抑郁的可行性分析[J].中国实用神经疾病杂志,2017,20(4):114-116.
[10]吴泉.益肾疏肝汤治疗脑卒中后抑郁症72例[J].陕西中医学院学报,2013(6):55-56.
[11]胡丹,盛蕾.加味柴胡疏肝颗粒辅助治疗缺血性脑卒中后抑郁的疗效观察[J].中草药,2016,47(21):3866-3870.
[12]周曾璇,刘柏炎.脑卒中后抑郁与痰瘀理论[J].长春中医药大学学报,2015(2):221-223.
[13]杨林.论肝郁与抑郁症[J].陕西中医,2000,21(6):260-261.
[14]苏杰,吴春霞.卒中后抑郁临床诊疗[J].实用中医内科杂志,2015(4):61-62.
[15]孟毅,刘志勇,乔明亮,等.177例脑卒中后抑郁病例中医证候分布特点[J].中国中医急症,2014,23(2):260-261,297.
[16]胡艳萍,张晋吉,赵玉敏,等.通络祛痰汤联合西药治疗卒中后抑郁疗效观察[J].中国实用医药,2015(11):208-209.
[17]刘占国,王慧萍.柴胡加龙骨牡蛎汤合黛力新治疗脑卒中后抑郁30例[J].江西中医药,2015(5):39-40.
[18]任宝龙,张振帅,赵晓燕,等.归脾汤加减联合黛力新治疗脑卒中后抑郁疗效的临床观察[J].中国初级卫生保健,2015(2):110-111.
[19]郑锦英.甘麦大枣汤合酸枣仁汤加减治疗脑卒中后抑郁疗效观察[J].北京中医药,2009,28(4):291-292.
[20]周勇,龙明,冉宏.西酞普兰联合养血清脑颗粒治疗脑卒中后抑郁的临床观察[J].中国药房,2014(12):1105-1107.
[21]陈江波.舒肝解郁胶囊与帕罗西汀治疗脑卒中后抑郁临床疗效对比分析[J].中西医结合研究,2015(3):138-139,141.
[22]宋昊,马建东,陈永新,等.解郁丸联合银杏叶胶囊治疗脑卒中后抑郁症的疗效分析[J].中国中医药科技,2014,21(6):671-672.
[23]白小利,杜晓伟,张灿飞,等.乌灵胶囊治疗卒中后抑郁有效性与安全性的系统评价[J].中国循证医学杂志,2014(9):1104-1111.
[24]蒋成志,苏海林,林红旭,等.中医康复治疗脑卒中后抑郁的研究近况[J].四川中医,2014(8):171-175.
[25]刘弘文.从肝脾论治脑卒中后抑郁的临床疗效[J].中国中医药现代远程教育,2015(5):25-27.
[26]彭慧渊,叶家盛,何希俊,等.电针与氟西汀胶囊治疗脑卒中后抑郁症临床随机对照研究[J].吉林中医药,2011(10):990-992.
[27]高潇,王志婕,董施秋,等.穴位注射金丝桃素单体结合捏脊疗法治疗脑卒中后抑郁的临床观察[J].中医药信息,2015(2):102-104.
[28]邓艳莉,徒成云,刘巧,等.温和灸治疗卒中后抑郁肝气郁结证40例临床观察[J].内蒙古中医药,2014(35):94-95.
[29]蔡经宇.重复经颅磁刺激辅助治疗脑中风后抑郁症的临床研究[J].河南医学研究,2013,22(3):365-366.
[30]邹生燕,刘泓.中医辨证施护结合艾灸疗法对卒中后抑郁心脾两虚型疗效观察[J].辽宁中医药大学学报,2014(4):196-198.
[31]岳红霞.针灸联合体感音乐治疗对脑卒中后抑郁患者康复的影响[J].吉林中医药,2015,35(2):203-205.
[32]张叶青,陈眉.中药辨证施治干预脑卒中后抑郁的临床研究[J].中华中医药学刊,2012(4):808-810.
[33]俞雯雯,谢海芳,蔡伯艳.卒中后抑郁的中西医治疗探讨[J].江西中医药,2007,38(7):77-78.