藏西药联合对卒中后抑郁的预防性研究  

PREVENTIVE RESEARCH ON COMBINATION OF TRADITIONAL TIBETAN MEDICINE SALIDROSIDE WITH WESTERN MEDICINE PAROXETINE HYDROCHLORIDE TO TREAT PATIENTS WITH POST- STROKE DEPRESSION

作　　者：王兰桂[1] 赵秀丽[1] 黄茜[1] 马丽萍[1] 鄂维建 铁婷婷 张璟[1] 

机构地区：[1]青海大学附属医院,西宁810001

出　　处：《青海医学院学报》2015年第3期188-193,共6页Journal of Qinghai Medical College

基　　金：青海大学附属医院中青年科研基金项目(ASRF-2011-04)

摘　　要：目的探讨藏药红景天和抗抑郁药盐酸帕罗西汀对卒中后抑郁(PSD)的预防作用及其可能机制。方法收集西宁地区脑卒中汉族患者,随机分为对照组、盐酸帕罗西汀组、联合用药组(盐酸帕罗西汀+红景天),各40例,所有患者在治疗前,治疗30天、60天进行汉密尔顿抑郁量表评分(HAMD评分)、神经功能缺损程度评分(NIHSS评分)、日常生活能力量表评分(Barthel指数),计算3组治疗30天、60天PSD发生率,同时检测所有患者在治疗前,治疗30天、60天血浆hs-CRP水平。并对上述结果行相关分析。结果 1)联合用药组在治疗30天时PSD发生率低于对照组,差异具有统计学意义(P<0.05),盐酸帕罗西汀组和联合用药组在治疗60天时PSD发生率低于对照组,差异具有统计学意义(P<0.05),联合用药组在治疗30天和60天时PSD发生率低于盐酸帕罗西汀组,但差异无统计学意义(P>0.05);2)联合用药组和盐酸帕罗西汀组治疗30天和60天时HAMD评分、NIHSS评分及Barthel指数低于对照组,同时联合用药组低于盐酸帕罗西汀组,差异具有统计学意义(P<0.05);3)联合用药组和盐酸帕罗西汀组治疗30天和60天时血浆hs-CRP水平低于对照组,联合用药组低于盐酸帕罗西汀组,差异具有统计学意义(P<0.05)。结论藏药红景天和抗抑郁药盐酸帕罗西汀对西宁地区卒中后抑郁有一定预防作用,同时可改善卒中患者神经功能和生活质量,且联合应用效果更佳;预防作用可能机制之一:通过减轻炎症反应来实现。Objective To investigate the preventive effect and possible mechanism of combining traditional Ti- betan medicine Salidroside with western medicine Paroxetine hydrochloride to treat patients with post - stroke depression （PSD）. Methods 120 Han nationality patients with stroke were randomly divided into three groups：control,Paroxetine and combination group were selected from Qinghai university affiliated hospital. HAMD, NIHSS and ADL were scored and Nephelometry was used to determine the concentration of plasma hs - CRP in three groups before treatment and 30 and 60 days after treatment. PSD incidence of three groups were calculated after 30 and 60 days of treatment. Results 1 ） PSD incidence in combination group were lower than that in control group after 30 days of treatment. PSD incidence in Paroxetine and combination group were lower than that in control group after 60 days of treatment and they showed statistical differences （ P 〈 0.05 ）. PSD incidence in combination group were lower than Paroxetine group after 30 and 60 days of treatment, but the differences had no statistical significance （ P 〉 0.05 ）. 2 ） HAMD scores, NIHSS scores and ADL scores in combination group and Paroxetine group were lower than those in control group after 30 and 60 days of treatment. HAMD scores, NIHSS scores and ADL scores in combination group were lower than those in Paroxetine group after 30 and 60 days of treatment, the differences had statistical signifi- cance （ P 〈 0.05 ）. 3 ） The plasma level of hs - CRP in combination group and Paroxetine group were lower than those in control group after 30 and 60 days of treatment;the plasma level of hs - CRP in combination group were lower than those in Paroxetine group after 30 and 60 days of treatment, the differences had statistical significance （P 〈 0.05 ）. Conclusions Traditional Tibetan medicine Salidroside and western medicine Paroxetine hydrochloride have preventive effect on patients with PSD in Xining area, and they may improve the neurolog

关 键 词：卒中后抑郁 预防 红景天 盐酸帕罗西汀 

分 类 号：R743.3[医药卫生—神经病学与精神病学]