通窍活血胶囊联合草酸艾司西酞普兰对脑卒中后抑郁患者神经功能、认知功能及脑血流量的影响  

Effect of Tongqiao Huoxue capsule combined with escitalopram oxalate on neurological function,cognitive function and cerebral blood flow in patients with post-stroke depression

作　　者：石磊[1] 张敏[1] 王新华[1] 刘恒方[1] 

机构地区：[1]河南省郑州市郑州大学第五附属医院神经内科,南阳450000

出　　处：《国际精神病学杂志》2017年第1期88-91,共4页Journal Of International Psychiatry

摘　　要：目的观察通窍活血胶囊联合草酸艾司西酞普兰对脑卒中后抑郁(PSD)患者神经功能、认知功能及脑血流量的影响。方法将84例PSD患者分为对照组与观察组各42例,对照组采用草酸艾司西酞普兰治疗,观察组在此基础上加用通窍活血胶囊,均治疗8周,治疗前后采用美国国立卫生研究院卒中量表(NIHSS)评定患者神经功能,采用简易精神状态量表(MMSE)及汉密尔顿抑郁量表(HAMD)评定患者认知功能及抑郁状况的改善情况,并作脑CT灌注检查,测定患者脑血流量的变化,统计治疗不良反应。结果 (1)治疗8周,两组NIHSS、HAMD评分降低,MESS评分上升,与同组治疗前对比差异有统计学意义(P>0.05),观察组NIHSS、HAMD评分降低及MESS评分上升幅度均高于对照组(P<0.05);(2)治疗8周,两组CBV增加,MTT缩短,CBF上升,与同组治疗前对比差异有统计学意义(P<0.05),观察组CBV、CBF上升幅度及MTT降低幅度均高于对照组(P<0.05);(3)两组不良反应发生率对比差异无统计学意义(P>0.05)。结论在PSD患者的临床治疗中,采用通窍活血胶囊联合草酸艾司西酞普兰方案,可优化患者神经功能、认知功能,改善其抑郁状态及血脑灌注水平,且安全性良好。Objective To observe the effect of Tongqiao Huoxue capsule combined with escitalopram oxalate on neurological, cognitive function and cerebral blood flow in patients with post-stroke depression （ PSD ） . Methods Eighty-four patients with PSD were sent into the control group and the observation group, 42 cases in each group. The control group was treated with escitalopram oxalate. The observation group, based on the control group, was treated with Tongqiao Huoxue capsule. Both groups were treated for 8 weeks. Before and after treatment, the National Institutes of Health Stroke Scale （NIHSS） was used to evaluate the neurological function of patients, the Mini-mental Examina- tion （ MMSE ） and Hamilton Depression Scale （ HAMD ） were used to evaluate the cognitive function and relief of de- pression in patients. Cerebral CT perfusion examination was performed to determine the changes of cerebral blood flow, and the adverse reactions were statistically analyzed. Results After 8 weeks of treatment, the scores of N1HSS and HAMD decreased while score of MESS increased. There were significant differences in scores between before treatment and after 8 weeks （P〉0.05）, and the increase and decrease in the observation group were more significant than those in the control group （ P〈0.05 ）; After 8 weeks of treatment, CBV was increased, MTT was shortened and CBF was increased. Compared with those in the same group before treatment, there were significant differences （P〈 0.05 ）, and the increase and decrease in observation group were more significant than those in control group （ P 〈 0.05 ）; There was no significant difference in the incidence of adverse reactions between the two groups （P 〉 0.05 ） . Conclusion In the clinical treatment of patients with PSD, the application of Tongqiao Huoxue capsule combined with escitalopram oxa-late can optimize the neurological and cognitive function of patients, relieve depression and improve the blood perfusion level, with safety.

关 键 词：脑卒中后抑郁 通窍活血胶囊 草酸艾司西酞普兰 认知功能 

分 类 号：R749.053[医药卫生—神经病学与精神病学]