舒肝颗粒联合氟哌噻吨美利曲新治疗脑卒中后抑郁症的疗效观察
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摘要
目的探讨舒肝颗粒联合氟哌噻吨美利曲新(黛力新)治疗脑卒中后抑郁症(PSD)的疗效。方法 240例PSD患者随机分为对照组和研究组,每组120例。对照组口服黛力新早晚各1片。研究组在对照组治疗的基础上加用舒肝颗粒,3 g/次,2次/d。2组疗程均为8周。比较2组患者临床疗效以及血清神经递质水平。结果研究组总有效率为89.17%显著高于对照组的75.83%(P<0.05)。研究组HAMD评分整体水平显著低于对照组(F组间=36.54,P<0.05),2组患者HAMD评分均随治疗时间延长而降低(F组间=668.57,P<0.05),研究组HAMD评分降低幅度显著大于对照组(F组间×时间=18.49,P<0.05)。研究组SDS评分整体水平显著低于对照组(F组间=23.57,P<0.05),2组患者SDS评分均随治疗时间延长而降低(F组间=354.69,P<0.05),研究组SDS评分降低幅度显著大于对照组(F组间×时间=12.87,P<0.05)。2组患者治疗后5-HT水平显著升高(t分别为26.74、19.24,P<0.05),研究组显著高于对照组(P<0.05)。2组患者治疗后NE水平显著升高(t分别为33.68、24.84,P<0.05),研究组显著高于对照组(P<0.05)。2组患者治疗后DA水平显著升高(t分别为27.59、17.23,P<0.05),研究组显著高于对照组(P<0.05)。结论舒肝颗粒联合黛力新治疗脑卒中抑郁症疗效显著,对改善神经受损有积极作用。
Objective To observe the therapeutic effects of Shugan granules combined with deanxit on post-stroke depression( PSD). Methods 240 patients with PSD were randomly divided into control group and research group,with 120 cases in each group. The patients in control group were treated by oral deanxit,1 tablet in the morning and in the evening,respectively,however,the patients in research group,on the basis of control group,were treated by Shugan granules,3 g once,twice a day,with a treatment course of 8 weeks for both groups. The clinical curative effects of and serum levels of neurotransmitters were observed and compared between two groups. Results The clinical curative effects in research group were suprior to those in control group,and the total effective rate was significantly higher than that in control group( P <0. 05). The HAMD scores in research group were significantly lower than those in control group( P < 0. 05),moreover,the HAMD scores in both groups were decreased with the treatment time going on( P < 0. 05),and the decrease extent of HAMD scores in research group was significantly greater than that in control group( P < 0. 05). The SDS scores in research group were significantly lower than those in control group( P < 0. 05). In addition the SDS scores in both groups were decreased with the treatment time going on( P < 0. 05),and the decrease extent of SDS scores in research group was significantly greater than that in control group( P < 0. 05). After 5-day treatment,the levels of 5-HT were increased significantly in both groups( P <0. 05),which in research group were significantly higher than those in control group. In addition the levels of NE were increased significantly in both groups( P < 0. 05). After treatment the levels of NE and DA were increased significantly in both groups( P < 0. 05),which in research group were significantly higher than those in control group. Conclusion Shugan granules combined with deanxit has obvious therapeutic effects on PSD,which has a positive effect in improving nerve damage.
Objective To observe the therapeutic effects of Shugan granules combined with deanxit on post-stroke depression( PSD). Methods 240 patients with PSD were randomly divided into control group and research group,with 120 cases in each group. The patients in control group were treated by oral deanxit,1 tablet in the morning and in the evening,respectively,however,the patients in research group,on the basis of control group,were treated by Shugan granules,3 g once,twice a day,with a treatment course of 8 weeks for both groups. The clinical curative effects of and serum levels of neurotransmitters were observed and compared between two groups. Results The clinical curative effects in research group were suprior to those in control group,and the total effective rate was significantly higher than that in control group( P <0. 05). The HAMD scores in research group were significantly lower than those in control group( P < 0. 05),moreover,the HAMD scores in both groups were decreased with the treatment time going on( P < 0. 05),and the decrease extent of HAMD scores in research group was significantly greater than that in control group( P < 0. 05). The SDS scores in research group were significantly lower than those in control group( P < 0. 05). In addition the SDS scores in both groups were decreased with the treatment time going on( P < 0. 05),and the decrease extent of SDS scores in research group was significantly greater than that in control group( P < 0. 05). After 5-day treatment,the levels of 5-HT were increased significantly in both groups( P <0. 05),which in research group were significantly higher than those in control group. In addition the levels of NE were increased significantly in both groups( P < 0. 05). After treatment the levels of NE and DA were increased significantly in both groups( P < 0. 05),which in research group were significantly higher than those in control group. Conclusion Shugan granules combined with deanxit has obvious therapeutic effects on PSD,which has a positive effect in improving nerve damage.
引文
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7 戈宏焱,陈博,许丹,等.柴胡皂苷A对抑郁模型大鼠脑中单胺类神经递质及其代谢产物含量的影响.高等学校化学学报,2008,29:1535-1538.
8 张静艳,张晓杰.柴胡皂苷对抑郁模型大鼠海马乙酰胆碱代谢及组织形态学影响的实验研究.齐齐哈尔医学院学报,2011,32:506-508.
9 戈宏焱,陈博,万有贵.柴胡皂苷对抑郁症大鼠海马BDNF表达的影响.中国老年学杂志,2012,32:1209-1211.
10 王景霞,张建军,李伟,等.芍药苷抗抑郁作用与NO/c GMP通路相关性研究.中药与临床,2012,25:27-28.
11 王君明,张月月,张蓓,等.牡丹皮水提物抗抑郁活性研究.时珍国医国药,2013,12:1579-1581.
12 蒋麟,张廷模.越鞠丸用于治疗抑郁症的探讨.国医论坛,2004,19:15-17.
2 Gyagenda JO,Ddumba E,Odokonyero R,et al.Post-stroke depression among stroke survivors attending two hospitals in kampala uganda.Afr Health Sci,2015,15:1220-1231.
3 中华医学会精神科学会主编.中国精神障碍分类与诊断标准.第3版.南京:东南大学出版社,2000.
4 刘婕主编.疾病和有关健康问题的国际统计分类:ICD-10与ICD-9对照实用指导.第1版.南昌:江西科学技术出版社,2003.
5 中华中医药学会脑病专业委员会.抑郁症中医证候诊断标准及治疗方案.北京中医药大学学报,2011,34:810-811.
6 中华中医药学会主编.中医内科常见病诊疗指南.第1版.北京:中国中医药出版社,2008.231-250.
7 戈宏焱,陈博,许丹,等.柴胡皂苷A对抑郁模型大鼠脑中单胺类神经递质及其代谢产物含量的影响.高等学校化学学报,2008,29:1535-1538.
8 张静艳,张晓杰.柴胡皂苷对抑郁模型大鼠海马乙酰胆碱代谢及组织形态学影响的实验研究.齐齐哈尔医学院学报,2011,32:506-508.
9 戈宏焱,陈博,万有贵.柴胡皂苷对抑郁症大鼠海马BDNF表达的影响.中国老年学杂志,2012,32:1209-1211.
10 王景霞,张建军,李伟,等.芍药苷抗抑郁作用与NO/c GMP通路相关性研究.中药与临床,2012,25:27-28.
11 王君明,张月月,张蓓,等.牡丹皮水提物抗抑郁活性研究.时珍国医国药,2013,12:1579-1581.
12 蒋麟,张廷模.越鞠丸用于治疗抑郁症的探讨.国医论坛,2004,19:15-17.