舒肝颗粒治疗脑梗死后抑郁症的疗效及对BDNF和炎症因子水平的影响  

The Curative Effect of Shugan Granule in the Treatment of Post-stroke Depression and Effect on BDNF and Inflammatory Factors

作　　者：刘晓溪 孙海民 商萌萌 李会敏[1] 史福平[1] 张杏红[1] 宋月平[1] LIU Xiao-xi;SUN Hai-min;SHANG Meng-meng;LI Hui-min;SHI Fu-ping;ZHANG Xing-hong;SONG Yue-ping(Department of Neurology, Affiliated Hospital of Hebei University, Baoding 071000, China)

机构地区：[1]河北大学附属医院神经内科,河北保定071000

出　　处：《中国药学杂志》2018年第13期1140-1144,共5页Chinese Pharmaceutical Journal

基　　金：河北省重点研发计划项目资助(18277795D);河北省卫生厅指导项目资助(ZD20140041);河北大学附属医院青年科研基金项目资助(2016Q015)

摘　　要：目的探讨舒肝颗粒治疗脑梗死后抑郁症(PSD)的疗效及对脑源性神经营养因子(BDNF)和炎症因子水平的影响。方法 160例PSD患者随机分为对照组和研究组,每组80例。对照组在常规治疗基础上给予氢溴酸西酞普兰,20mg·d^(-1)口服;研究组在对照组的基础上给予舒肝颗粒,每次3 g(1袋),2次·d^(-1),温水冲服。8周为1个疗程。比较两组患者的临床疗效;HAMD评分;BI指数,BDNF以及炎症因子水平的差异。结果研究组临床总有效率88.75%显著高于对照组76.25%,差异有统计学意义(χ~2=4.329,P<0.05)。重复测量资料方差分析结果显示,研究组HAMD评分整体水平显著低于对照组(F_(组间)=36.541,P<0.05),两组患者HAMD评分均随治疗时间延长而降低(F时间=668.574,P<0.05),研究组HAMD评分降低幅度显著大于对照组(F_(交互)=18.495,P<0.05)。研究组BI指数和BDNF整体水平显著高于对照组(F_(组间)分别为48.147,41.561,P<0.05),两组患者BI指数和BDNF水平均随治疗时间延长而升高(F时间分别为316.586,595.864,P<0.05),研究组BI指数和BDNF水平升高幅度显著高于对照组(F_(交互)=22.849,10.515,P<0.05)。研究组TNF-α,IL-6以及hs-CRP整体水平显著低于对照组(F_(组间)分别为117.849,85.168,66.763,P<0.05),两组患者TNF-α,IL-6以及hs-CRP水平均随治疗时间延长而降低(F时间分别为864.584,697.717,1 037.167,P<0.05),研究组TNF-α,IL-6以及hs-CRP水平降低幅度显著大于对照组(F_(交互)分别为31.271,26.174,17.585,P<0.05)。两组患者不良反应无显著性差异(11.25%与18.75%,χ~2=1.765,P>0.05)。结论在常规西药治疗的基础上加用舒肝颗粒,能够更好的改善PSD患者的抑郁程度,降低炎症因子水平。OBJECTIVE To investigate the curative effect of Shugan granule in the treatment of post-stroke depression （PSD） and effect on brain devived neurotrophic factor（BDNF） and inflammatory factors.METHODS Eighty Patients with PSD were randomly divided into control group and study group, 80 cases in each group. Besides routine treatment, control group received citalopram hydrobromide 20 mg·d-1. Study group received Shugan granule 1 bags·time^-1, twice a day based on control group.8 weeks for a course of treatment. HAMD scores, BI index, BDNF and inflammatory factors levels were compared.RESULTS The total effective rate in study group was significantly higher than that in control group[71 cases,88.75% vs 61 cases, 76.25%, χ^2=4.329, P〈0.05]. Repeated measurement data analysis of variance showed, the overall scores of HAMD in study group were significantly lower than those in control group [Fgroup=36.541, P〈0.05]. The HAMD scores of the two groups decreased with the extension of treatment time [Ftime=668.574, P〈0.05].The reduction extent of HAMD score in study group was significantly higher than that in control group[Fgroup×time=18.495, P〈0.05]. BI indexes and BDNF levels in study group were significantly higher than those in control group [Fgroup=48.147, 41.561, P〈0.05]. BI indexes and BDNF levels of two groups increased with the extension of treatment time [Ftime=316.586, 595.864, P〈0.05]. The increasing extent of BI indexes and BDNF levels in study group was significantly higher than that in control group [Fgroup×time=22.849, 10.515, P〈0.05]. The overall levels of TNF-α, IL-6 and hs-CRP in study group were significantly lower than those in control group [Fgroup=117.849, 85.168, 66.763, P〈0.05]. TNF-α, IL-6 and hs-CRP levels of two groups decreased with the extension of treatment time [Ftime=864.584, 697.717, 1 037.167, P〈0.05]. The reduction extent of TNF-α, IL-6 and hs-CRP levels in study group was significantly higher than that in control group[Fgroup×time=31.271, 26.174, 17.585, P�

关 键 词：脑梗死后抑郁症 舒肝颗粒 脑源性神经营养因子 炎症因子 临床疗效 

分 类 号：R969[医药卫生—药理学]