养血清脑颗粒治疗卒中后抑郁的疗效及对脑白质结构改变的影响  

Antidepressive Efficacy of Cerebralcare Granule( R) in the Treatment of Post-stroke Depression and Influences on White-matter Structural Alterations

作　　者：许孝南 马婷[2] 陈旭辉[1] 虢周科[3] 朱治山[4] 刘淑云 李梅笑[6] 李晶 刘相城 吴军[1] 

机构地区：[1]北京大学深圳医院神经内科,广东深圳518036 [2]哈尔滨工业大学深圳研究生院,广东深圳518055 [3]深圳市中医院神经内科,广东深圳518033 [4]深圳市罗湖区人民医院神经内科,广东深圳518001 [5]深圳市龙华新区人民医院神经内科,广东深圳518110 [6]深圳市龙岗区人民医院神经内科,广东深圳518172 [7]深圳市宝安区沙井人民医院神经内科,广东深圳518104

出　　处：《中风与神经疾病杂志》2016年第5期438-441,共4页Journal of Apoplexy and Nervous Diseases

基　　金：深圳市卫生局科技项目(No.201302054)

摘　　要：目的利用磁共振弥散张量成像(DTI)技术,观察养血清脑颗粒治疗卒中后抑郁(PSD)的疗效差异,以及其对脑白质结构改变的影响。方法给予卒中后抑郁患者养血清脑颗粒4 g,口服,3次/d;疗程12 w,治疗前、后均收集汉密尔顿抑郁量表评分(HAMD-24)、DTI扫描数据。治疗后HAMD-24≤8分纳入治愈组,反之纳入难治组。比较两组治疗前、后FA值变化情况。结果养血清脑颗粒治愈率约44.6%。与治疗前相比,治愈组的左侧额叶FA值治疗后明显升高(P<0.05);比较两组治疗前的FA值,发现难治组左侧额叶、右侧海马的基线FA值低下(P<0.05)。结论养血清脑颗粒治疗PSD有效。PSD患者存在可逆性前额叶深部白质损伤;且难治性PSD患者左侧额叶、右侧海马的基线FA值低下,提示DTI可作为抗抑郁疗效评估的预测指标。Objective To study the antidepressive efficacy in the treatment of post-stroke depression（ PSD） with Cerebralcare Granule（ R） by Diffusion Tensor Magnetic Resonance Imaging（ DTI）,while observing influences on white-matter structural alterations. Methods PSD cases were given Cerebralcare Granule（ R） 4g,tid,peros while they were checked by DTI sequence before and after treatment. Treatment course lasted for 12 weeks. Antidepressive efficacies were observed by HAMD-24 score. Cure group was defined as HAMD score ≤8 while Resistent group was≥9. Comparisons of FA value between two groups before and after antidepresive theraopy were observed. Results Cerebralcare Granule（ R） ＇s cure rate is was about 44. 6% .FA value of left frontal lobe was signficance significant higher after antidepresive treatment in patients in cure group（ P〈0. 05）. Otherwise,comparison with patients in cure group,resistent patients had lower baseline FA value in left frontal lobe and right hippocampus before treatment（ P〈0. 05）. Conclusion Cerebralcare Granule（ R） is effective in the treatment of PSD.. There is reversible injury in prefrontal-lobe white matter of PSD patients,while low baseline FA value in left frontal lobe and right hippocampus of resistent patients which indicating an excellent antidepresive evaluating index of DTI.

关 键 词：卒中后抑郁 弥散张量成像 疗效 养血清脑颗粒 

分 类 号：R743.3[医药卫生—神经病学与精神病学]