调肝化瘀通络法联用SSRIs氟西汀治疗卒中后抑郁症（PSD）疗效观察
摘要
目的：本课题旨在用中西医结合的方法对脑卒中后抑郁症(1周后恢复期内)的患者进行干预治疗,观察调肝化瘀通络方联合SSRI(神经递质保护剂)氟西汀在改善卒中后抑郁症(PSD)的多样化躯体症状和抑郁情绪方面的疗效。方法：从新疆医科大一附院和自治区中医院筛PSD患者93例,均控制血压、血糖、血脂正常,并给予卒中常规药物治疗,且配合康复锻炼。将入选患者分为三组：综合治疗组(中西医结合)31例、实验组(单纯中药治疗)31例、对照组(西药治疗)31例,分别进行抗抑郁中西药物的治疗,采用国际量表问诊的方式,分别观察治疗前和治疗6周后的中医抑郁证候评分变化和汉密尔顿(HAMD)评分的变化,用Microsoft Excel2003建立数据库,用SPSS17.0进行统计分析,用方差检验多组间两两比较治疗前后评分差异。结果：1、中药组在改善抑郁临床躯体化症状的减分率与西药组有有统计学意义,且明显优于西药组。2、中西医结合组分别与单独用药组在改善临床症状减分率上比较有统计学意义,显示联合用药对卒中后抑郁症的治疗有疗效明显好于单纯的中药组和西药组。3、三组治疗前后的HAMD评分差值经两两比较可知,中西医结合治疗组分别与单纯中药组、单纯西药组比较均有有统计学意义,说明联合用药在治疗卒中后抑郁症与单独用药相比,改善抑郁的精神症状有叠加效应。4、单纯中药组与单纯西药组治疗前后的HAMD评分差值比较无统计学意义,说明中药与氟西汀在改善卒中后抑郁症患者的精神症状方面疗效相当。结论：自拟调肝化瘀通络汤结合氟西汀在辩证治疗脑卒中抑郁症,改善患者躯体化症状、精神症状方面有明显的协同作用,且副作用轻微,值得在临床上大力推广。
Objective:To attempt to use TCM and western intervention into the treatment of PSD (1-3mon), to explore on therapeutic effect of the PSD variation soma syndromes and the emotion obstacled By Tiaoganhuayutongluo unite SSRIs-FLU.Method:To collect patients 93 from the xinyidayifuyuan and zizhiqu zhongyiyuan, all the patients were given the basic therapy of cerebrovascular disease eqnally andphysiotherapyor occupational therapy individually.randomized grouping, divided into the treatment group TGHYTLF unit flu(31case),control group FLU(31ease) and the test group TGHYTLF(31ease); using with the Questionnaire by professionals. Respectively observed and compared the index variation of depression HAMD and The symptoms of TCM. before and after the treatment 6 weeks later.using Microsoft Excel 2003 setup date,all date were statistically analyzed with the SPSS 17.0 software package by using T test. Significance level was set as P< 0.05.Results:1.the score decrease rate of test group with a significant difference comparing to the control group and be superior to remiting on clinical soma syndromes. 2.the treatment group has cooperation_on adjusting nerve-endocrinology.3. The variation of HAMD in the treatment group and the other group has significant by statistical tests,to show unite-medicine has cooperation effection on emotional disorder.4.The variation of HAMD in control group and the test group was not significant by statistical tests. Conclusions:TGHYTLF and flu be superior to remiting on the PSD ofclinical soma syndromes and emotion obstacled, reduce clinical scores, unite-medicine has better curative effection in the treatment of PSD.
Objective:To attempt to use TCM and western intervention into the treatment of PSD (1-3mon), to explore on therapeutic effect of the PSD variation soma syndromes and the emotion obstacled By Tiaoganhuayutongluo unite SSRIs-FLU.Method:To collect patients 93 from the xinyidayifuyuan and zizhiqu zhongyiyuan, all the patients were given the basic therapy of cerebrovascular disease eqnally andphysiotherapyor occupational therapy individually.randomized grouping, divided into the treatment group TGHYTLF unit flu(31case),control group FLU(31ease) and the test group TGHYTLF(31ease); using with the Questionnaire by professionals. Respectively observed and compared the index variation of depression HAMD and The symptoms of TCM. before and after the treatment 6 weeks later.using Microsoft Excel 2003 setup date,all date were statistically analyzed with the SPSS 17.0 software package by using T test. Significance level was set as P< 0.05.Results:1.the score decrease rate of test group with a significant difference comparing to the control group and be superior to remiting on clinical soma syndromes. 2.the treatment group has cooperation_on adjusting nerve-endocrinology.3. The variation of HAMD in the treatment group and the other group has significant by statistical tests,to show unite-medicine has cooperation effection on emotional disorder.4.The variation of HAMD in control group and the test group was not significant by statistical tests. Conclusions:TGHYTLF and flu be superior to remiting on the PSD ofclinical soma syndromes and emotion obstacled, reduce clinical scores, unite-medicine has better curative effection in the treatment of PSD.
引文
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