中药辅助氟西汀治疗脑卒中后抑郁的疗效及对药物依赖性的影响  

Efficacy of fluoxetine combined with traditional Chinese medicine for treating post-stroke depression and the influence on drug dependence

作　　者：张志英[1] 郭素芹[2] 

机构地区：[1]新乡医学院第二附属医院精神一科,河南新乡453002 [2]新乡医学院第二附属医院儿童少年科,河南新乡453002

出　　处：《中国临床研究》2016年第5期613-616,共4页Chinese Journal of Clinical Research

基　　金：河南省科技攻关项目(082102310037)

摘　　要：目的探讨中药辅助氟西汀治疗脑卒中后抑郁的疗效及对药物依赖性的影响。方法选取2012年8月至2014年8月脑卒中后抑郁住院治疗患者120例,采用随机数字对照表分为观察组与对照组,每组60例。对照组给予氟西汀20 mg/d口服,1次/d;观察组在对照组基础上给予六郁汤加味水煎300 ml口服,分2次用药,1剂/d。30 d为一个疗程,均治疗两个疗程。评估两组临床疗效及药物副作用;治疗前后行中医症状评分、汉密尔顿抑郁量表(HAMD)评分、日常生活能力ADL量表(Barthel指数)评分,测定肿瘤坏死因子-α(TNF-α)、重组人白介素(IL)-1β及IL-6水平。结果观察组治疗有效率为91.67%,显著高于对照组78.33%,差异具有统计学意义(P<0.05);观察组治疗后精神不振、失眠多梦、忧郁不畅、不思饮食评分均显著低于对照组(P均<0.05);观察组治疗后HAMD评分显著低于对照组,ADL评分显著高于对照组(P均<0.05);观察组治疗后TNF-α、IL-1β、IL-6水平均显著低于对照组(P<均0.05)。两组治疗后呕吐、皮疹、头晕、药物依赖性发生率无明显差异(P均>0.05)。结论六郁汤加味辅助氟西汀治疗脑卒中后抑郁能够有效缓解或消除抑郁情绪,提高临床疗效。Objective To investigate the therapeutic effect of fluoxetine combined with traditional Chinese medicine for the treatment of post-stroke depression and the influence on drug dependence. Methods A total of 120 hospitalized patients with post stroke depression from August 2012 to August 2014 were selected and divided into observation group and control group by random number table method（ each n = 60）. Fluoxetine was given（ 20 mg qd,orally） in control group,and fluoxetine plus modified Liuyu decoction（ decocting to 300 ml with water,150 ml bid,orally） were given in observation group. All patients in two groups received the treatment of two courses（ each course was 30 days）. The clinical therapeutic effect and drug side effects between two groups were observed; the traditional Chinese medicine symptom scores,Hamilton Depression Rating Scale（ HAMD） score and Activities of Daily Living（ ADL） scale（ Barthel index） were evaluated before and after treatment; serum levels of tumor necrosis factor-α（ TNF-α）,recombinant human interleukin-1β（ IL-1β） and interleukin-6（ IL-6） were detected before and after treatment. Results The effective rate in observation group（ 91. 67%）was significantly higher than that in control group（ 78. 33%）（ P 0. 05）. After the treatment,the scores of lassitude,insomnia and dreamful sleep,depression and poor appetite in the observation group were significantly lower than those in control group（ all P 0. 05）. Compared with control group after the treatment,the HAMD score significantly decreased,and ADL score significantly increased in the observation group（ all P 0. 05）. After the treatment,serum levels of TNF-α,IL-1β and IL-6 in the observation group were significantly lower than those in control group（ all P 0. 05）. There were no significant differences in the incidence rates of vomiting,rash,dizziness and drug dependence between two groups（ P 0. 05）. Conclusion Fluoxetine combined with Liuyu decoction in the treatment of post

关 键 词：抑郁症 脑卒中 六郁汤 炎性因子 药物依赖性 

分 类 号：R749.12[医药卫生—神经病学与精神病学]