摘要
目的:研究柴胡疏肝汤加减对肝气郁结型卒中后抑郁患者疗效及血清神经递质、神经功能恢复的影响。方法:选取符合纳入标准的肝气郁结型卒中后抑郁患者,随机分为对照组和观察组,每组40例。对照组给予艾司西酞普兰治疗,观察组给予艾司西酞普兰联合柴胡疏肝汤治疗,疗程为4周。评价患者治疗前后抑郁程度(HAMD评分)、神经功能缺损程度(NIHSS评分)、日常生活能力(MBI评分)和中医症候评分,检测脑源性神经营养因子(BDNF)含量、5-羟色胺(5-HT)和去甲肾上腺素(NE)含量,评价临床疗效。结果:治疗后,观察组HAMD评分、NIHSS评分低于对照组,MBI评分高于对照组(P <0. 05);观察组血清BDNF、5-HT和NE含量均高于对照组(P <0. 05),观察组中医症候评分低于对照组(P <0. 05);观察组总有效率高于对照组(P <0. 05)。结论:柴胡疏肝汤治疗肝气郁结型卒中后抑郁,疗效确切,能够显著改善患者抑郁症状,促进神经功能恢复,提高生活质量,其机制可能与上调血清BDNF、5-HT和NE水平有关。
Objective: To study the effect of modified Chaihu Shugan Decoction on post-stroke depression with liver-qi stagnation and its effect on serum neurotransmitter and nerve function recovery. Methods: 80 cases of post-stroke depression with liver-qi stagnation were randomly divided into the control group( n = 40) and the observation group( n = 40). The control group was treated with Escitalopram; on which basis,the observation group was also treated with modified Chaihu Shugan Decoction. The treatment course was 4 weeks. The degree of depression( HAMD score),the degree of nerve function defect( NIHSS score),daily living ability( MBI score) and TCM syndrome integral were evaluated before and after the treatment. The contents of brain derived neurotrophic factor( BDNF),5-serotonin( 5-HT) and norepinephrine( NE) were measured and the curative effect was evaluated. Results: After the treatment,HAMD score and NIHSS score were lower,and MBI score was higher in the observation group than those in the control group( P < 0. 05). The serum levels of BDNF,5-HT,and NE were higher in the observation group than those in the control group( P < 0. 05). The TCM syndrome integral was lower in the observation group than that in the control group( P < 0. 05). The total effective rate was higher in the observation group than that in the control group( P < 0. 05). Conclusion:Modified Chaihu Shugan Decoction is effective for post-stroke depression with liver-qi stagnation. It can significantly improve the depressive symptoms,promote the recovery of nerve function and improve the quality of life,which may be related to the up-regulation of serum levels of BDNF,5-HT,and NE.
引文
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