黄连温胆汤加味联合经颅磁刺激对卒中后抑郁状态患者血液流变学、抑郁状态、认知功能及血清BDNF的影响  

Effect of Modified Huanglian Wendang Decoction Combined with Transcranial Magnetic Stimulation on Jemorheology,Depression Status,Cognitive Function and Serum BDNF for Patients with Post-stroke Depression

作　　者：单永琳[1] 卞伟煜[1] 田雯艳[1] SHAN Yonglin;BIAN Weiyu;TIAN Wenyan(Department of Neurology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou Hebei 061000,China)

机构地区：[1]沧州中西医结合医院神经内科,河北沧州061000

出　　处：《四川中医》2022年第3期155-158,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：河北省中医药管理局2020年度中医药科研计划项目(编号:2020466)

摘　　要：目的:探讨黄连温胆汤加味联合经颅磁刺激(TMS)对卒中后抑郁状态(PSD)患者血液流变学、抑郁状态、认知功能及血清BDNF的影响。方法:选择2019年10月~2020年6月沧州中西医结合医院收治的80例卒中后抑郁患者,根据治疗方法不同将患者分为对照组和观察组,各40例。对照组给予黄连温胆汤加味治疗,观察组给予黄连温胆汤加味联合TMS治疗。比较两组疗效和安全性以及治疗前后血液流变学、抑郁状态、认知功能及血清BDNF水平组内变化和组间差异。结果:观察组治愈19例,有效18例,无效3例,治疗有效率92.50%,高于对照组75.00%(P<0.05)。治疗后观察组HAMD-17评分[(28.15±4.95)分vs(14.68±3.21)分]、SDS评分[(63.05±6.19)分vs(42.15±4.52)分]、血浆黏度[(1.81±0.35)mPa·s vs(1.53±0.21)mPa·s]、红细胞聚集指数[(3.97±0.56)vs(2.74±0.31)]、血沉[(18.24±3.26)mm/h vs(15.24±2.65)mm/h]降低,低于治疗前(P<0.05),且低于对照组治疗后水平(P<0.05),血清BDNF水平[(22.01±5.65)ng/ml vs(46.72±11.42)ng/ml]、MoCA评分[(20.35±2.24)分vs(25.32±4.69)分]、MMSE评分[(19.54±3.34)分vs(24.18±5.26)分]升高,高于治疗前(P<0.05),且高于对照组治疗后水平(P<0.05)。两组不良反应率比较无统计学差异(P>0.05)。结论:黄连温胆汤加味联合TMS治疗可改善PSD患者血液流变学、抑郁状态以及认知功能,优于单独黄连温胆汤加味治疗。Objective:To investigate the effect of Modified Huanglian Wandan Decoction combined with transcranial magnetic stimulation(TMS)on hemorheology,depression status,cognitive function and serum BDNF for post-stroke depression(PSD)patients.Methods:80 patients with post-stroke depression admitted to our hospital from October 2019 to June 2020 were selected and randomly divided into two groups according to the order of inclusion.The controlled group(40 cases)was given Modified Huanglian Wendan Decoction,while the treatment group(40 cases)was given Modified Huanglian Wendan Decoction combined with TMS.Efficacy and safety as well as changes in hemorheology,depression status,cognitive function and serum BDNF level before and after treatment were compared between the two groups.Results:In the treatment group,19 cases were cured,18 cases were effective,and 3 cases were ineffective.The effective rate of the treatment group was 92.50%,which was higher than 75.00%in the controlled group(P<0.05).The treatment group after treatment HAMD-17 scores[(28.15±4.95)scores VS(14.68±3.21)scores]and SDS score[(63.05±6.19)scores VS(42.15±4.52)scores],blood plasma viscosity[(1.81±0.35)mPa﹒s VS(1.53±0.21)mPa﹒s],erythrocyte aggregation index[(3.97±0.56)VS(2.74±0.31)],blood sedimentation reduction[(18.24±3.26)mm/h VS(15.24±2.65)mm/h]decreased,lower than before treatment(P<0.05)and that of the controlled group after treatment(P<0.05),serum BDNF levels[(22.01±5.65)ng/ml VS(46.72±11.42)ng/ml],MoCA score[(20.35±2.24)scores VS(25.32±4.69)scores],MMSE score[(19.54±3.34)scores VS(24.18±5.26)scores]increased,higher than before treatment(P<0.05)and that of the controlled group after treatment(P<0.05).There was no statistically significant difference in the adverse reaction rate between the two groups(P>0.05).Conclusion:Modified Huanglian Wandan Decoction combined with TMS can improve hemorheology,depression and cognitive function of PSD patients,which is better than that of TMS alone.

关 键 词：黄连温胆汤加味 经颅磁刺激 脑卒中 卒中后抑郁 血液流变 抑郁 认知功能 BDNF 

分 类 号：R743.3[医药卫生—神经病学与精神病学]