中西医结合治疗中风后抑郁症30例临床观察  

Clinical observation of combination of TCM and western medicine in Treating patients with Post-stroke Depression

作　　者：李君良[1] 洪杰斐[2] 林志雄[3] 

机构地区：[1]广东医学院附属医院神经内科,湛江524001 [2]广东医学院附属医院中医科,湛江524001 [3]广东医学院附属医院心理科,湛江524001

出　　处：《中国实用医药》2008年第23期36-38,共3页China Practical Medicine

摘　　要：目的观察中西医结合治疗中风后抑郁症的临床疗效。方法60例中风后抑郁症患者随机分为治疗组和对照组(各30例),观察治疗6周。对照组采用氟西汀治疗,治疗组在对照组基础上加郁星菖志汤治疗。于治疗前及治疗1周、2周、4周、6周末采用汉密顿抑郁量表(HAMD)评定抗抑郁疗效,记录不良反应;于治疗前及治疗6周末采用爱丁堡-斯堪的那维亚卒中量表(MESSS)评定神经功能缺损程度。结果治疗6w末治疗组与对照组治疗卒中后抑郁有效率分别为83.3%、73.3%;HAMD评分治疗组1w末起较治疗前有极显著性下降(P<0.01),对照组治疗2周末起有极显著性下降(P<0.01);MESSS评分两组6w末均较治疗前有极显著性下降(P<0.01),两组间比较有显著性差异(P<0.05)。两组不良反应均轻微,对比无显著性差异(P>0.05)。结论中西医结合治疗卒中后抑郁疗效较氟西汀好,且起效更快,不增加不良反应,有利于患者神经功能的康复。Objective To observe the effect of combination of TCM and western medicine in treating patients with post-stroke depression （PSD）. Methods 60 patients with PSD were randomly assigned into treatment and control groups （each n =30） for 6 weeks. Treatment with ＂Yuxingchangzhi decoction＂ and fluoxetine was initiated in treatment group, Controls were treated with fluoxetine. Treatment efficacy was evaluated with Hamilton Depression Scale （HAMD） before treatment and during the follow-up period （1 st, 2nd, 4th and 6th week） , respectively; side effects were recorded and stroke severity measured by MESSS before treatment and at 6th week. Results At 6th week, the total efficacy rate were 83.3 % in treatment group and 73.3 % in controls. In treatment group a significant decrease of the HAMD scores （P 〈 0.01 ） were seen in 1 st week, and 2nd week for Controls. Scores of the MESSS of both groups were decreased significantly at 6th week （ both P 〈 0. 01 ）, compared with controls there was significant difference in treatment group （P〈0.05）. There were no significant side effects in two groups （P〈0.05）. Conclusion Combination of TCM and western medicine is effective in the treatment of PSD, takes effects faster, has higher safety, and promote the rehabilitation of nervous function.

关 键 词：中风后抑郁症 郁星菖志汤 氟西汀 中西医结合 临床观察 

分 类 号：R749.1[医药卫生—神经病学与精神病学]