疏肝通络汤加减联合醒脑开窍针法治疗脑卒中后抑郁临床观察  

Clinical Observation of Modified Shugan Tongluo Tang Combined with Xingnao Kaiqiao Acupuncture for Post-stroke Depression

作　　者：王多德 席孝萍 张国忠 马砚涛 李有春 王金兰 王小凤 高立红 吉宗 邴俊林 唐锐天 赵会林 宗武三 WANG Duode;XI Xiaoping;ZHANG Guozhong;MA Yantao;LI Youchun;WANG Jinlan;WANG Xiaofeng;GAO Lihong;JI Zong;BING Junlin;TANG Ruitian;ZHAO Huilin;ZONG Wusan

机构地区：[1]武威市中医院,甘肃武威733000 [2]甘肃省金域医学检验集团,甘肃兰州730000

出　　处：《新中医》2018年第4期172-175,共4页New Chinese Medicine

基　　金：甘肃省中医药管理局科研课题(GZK-2014-82)

摘　　要：目的:观察疏肝通络汤加减联合醒脑开窍针法治疗脑卒中后抑郁(PSD)的临床疗效,及对患者汉密尔顿抑郁量表(HAMD)评分、血清脑源性神经营养因子(BDNF)、5-羟色胺(5-HT)水平的影响。方法:选取120例PSD患者,随机分为对照组与研究组各60例。2组均给予常规治疗,对照组在此基础上采用盐酸阿米替林片,研究组采用疏肝通络汤加减联合醒脑开窍针法,2组均持续治疗2月。观察2组治疗前后HAMD评分、血清BDNF及5-HT水平的变化。结果:治疗前,2组HAMD评分比较,差异无统计学意义(P>0.05)。治疗后,2组HAMD评分均较治疗前降低,差异均有统计学意义(P<0.05);研究组HAMD评分低于对照组,差异有统计学意义(P<0.05)。研究组临床疗效优于对照组,差异有统计学意义(Z=2.701,P<0.05)。治疗前,2组血清BDNF及5-HT水平比较,差异均无统计学意义(P>0.05)。治疗后,2组血清BDNF及5-HT水平均较治疗前升高,差异均有统计学意义(P<0.05);研究组血清BDNF及5-HT水平均高于对照组,差异均有统计学意义(P<0.05)。结论:疏肝通络汤加减联合醒脑开窍针法治疗PSD效果显著,可有效减轻患者的抑郁程度,提高血清BDNF及5-HT水平。Objective：To observe the clinical effect of modified Shugan Tongluo tang combined with Xingnao Kaiqiao acupuncture for post-stroke depression（PSD）and its effect on score of Hamilton depression rating scale（HAMD）,brain-derived neurotrophic factor（BDNF）,and level of 5-hydroxytryptamine（5-HT）.Methods：Selected 120 cases of patients with PSD and then divided them into the control group and the study group randomly,60 cases in each group.Both groups were givenroutine therapy,while the control group was additionally given amitriptyline tablets and the study group was additionally given modified Shugan Tongluo tang combined with Xingnao Kaiqiao acupuncture for treatment.The treatment lasted for two months in both groups.Observed scores of HAMD,changes of level of BDNF in serum,and 5-HT before and after treatment.Results：Before treatment,there was no significant difference being found in the comparison of scores of HAMD in both groups（P 0.05）.After treatment,the scores of HAMD in both groups were decreased when compared with those before treatment,differences being significant（P 0.05）.Scores of HAMD in the study group were lower than those in the control group,difference being significant（P 0.05）.The clinical effect in the study group was better than that in the control group,difference being significant（Z=2.701,P 0.05）.Before treatment,there was no significant difference being found in the comparisons of levels of BDNF in serum and 5-HT in both groups,differences being insignificant（P 0.05）.After treatment,levels of BDNF in serum and 5-HT in both groups were higher than those before treatment,differences beingsignificant（P 0.05）.Levels of BDNF in serum and 5-HT in the study group were higher than those in the control group,differences being significant（P 0.05）.Conclusion：The application of modified Shugan Tongluo tang combined with Xingnao Kaiqiao acupuncture has a significant clinical effect in treating PSD and can effectively relieve depression of patients and increas

关 键 词：脑卒中后抑郁(PSD) 疏肝通络汤 醒脑开窍针法 汉密尔顿抑郁量表(HAMD)评分 脑源性神经营养因子(BDNF) 5-羟色胺(5-HT) 

分 类 号：R743[医药卫生—神经病学与精神病学]