防郁小复方辨证干预缺血性卒中后抑郁临床研究  

Clinical study on PSD of different traditional Chinese medicine syndrome intervened with different small compound prescriptions of anti-depression

作　　者：裘涛[1] 孔丽娅[2] 陶水良[3] 张伟骏[1] 陈眉[1] QIU Tao;KONG Li-ya;TAO Shui-liang;ZHANG Wei-jun;CHEN Mei(Department of Neurology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China;Teaching and Research Section of Medical Statistics, College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China;Anatomy Institute, College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China)

机构地区：[1]浙江中医药大学附属第一医院神经内科,杭州310006 [2]浙江中医药大学基础医学院医学统计教研室,杭州310053 [3]浙江中医药大学基础医学院形态研究所,杭州310053

出　　处：《中华中医药杂志》2018年第2期780-783,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：浙江省自然科学基金项目(No.LY16H270002)~~

摘　　要：目的:在中医学辨证论治的核心思想指导下,对防郁小复方干预脑卒中后抑郁(PSD)进行临床研究,探讨其在缺血性卒中后减少PSD发病的作用,拓展中医药防治PSD的领域。方法:采用随机对照的研究方法,针对PSD发生中最重要的3个中医证素:痰、瘀、气虚,根据三者出现时期及程度的不同,辨证予防郁小复方,方随证变,干预治疗。结果:对急性缺血性卒中患者发病初期即辨证使用防郁小复方患者PSD的发生率亦较对照组下降,两组间比较,差异显著(P<0.01)。治疗组治疗后HAMD明显优于对照组(P<0.05)。经中药干预后中医证候要素中的痰湿、血瘀、气虚程度减轻,两组间比较,差异有统计学意义(P<0.01,P<0.05)。结论:防郁小复方的配伍组合体现了方随证变,方证相应的中医学辨证论治的精髓,使痰化、瘀祛、正扶、络通、郁解,能显著改善卒中后HAMD,减少PSD发病率,体现了中医学治未病的思想。Objective：Guided by the core idea of treatment based on syndrome differentiation of TCM,the clinical study on PSD intervened with small compound prescriptions of anti-depression was conducted.To explore its effects on reducing the incidence of PSD,and to expand the field of prevention and treatment in TCM.Methods：A method of randomized and controlled was accepted in this trail.According to phlegm,blood stasis,and qi deficiency,as for three most important syndrome elements of TCM induced PSD,and different periods and degrees of the three factors appeared,patients were given different small compound prescriptions of anti-depression.Results：The incidence of PSD of patients of acute ischemic stroke intervened with small compound prescriptions of anti-depression in their early stage was lower than that in the control group,and there was a statistical difference between the two groups（P〈0.01）.The recovery ability of neurological function was significantly better than the control group,and there was also a statistical difference between the two groups（P〈0.05）.The phlegm dampness,blood stasis and qi deficiency in TCM syndrome elements were reduced after intervention of TCM,and the difference was statistically significant between the two groups（P〈0.01,P〈0.05）.Conclusion：The combination of small compound prescriptions of anti-depression reflects the essence of TCM syndrome differentiation,which means the formula changes according to syndrome of TCM,that is formula syndrome correspondence.It could dissipate phlegm,dispel stasis,strengthen vital qi,dredge collateral,resolve qi stagnation,and improve the degree of neurological function deficiency after stroke obviously,and reduce the incidence of PSD.Those all reflect the thought of TCM preventive treatment of disease.

关 键 词：缺血性卒中 卒中后抑郁 证候要素 中药复方 

分 类 号：R277.7[医药卫生—中医学]