活血解郁汤结合氟西汀对卒中后抑郁血清脑源性神经营养因子的影响  

Effect of Huoxue Jieyu Decoction(活血解郁汤)Combined with Fluoxetine on Serum Brain-Derived Neurotrophic Factors in Patients with Post-Stroke Depression

作　　者：吴志鹏 王永盛 王苹莉 赵元琛 WU Zhipeng;WANG Yongsheng;WANG Pingli;ZHAO Yuanchen(Wenzhou Integrated Traditional Chinese and Western Medicine Hospital,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州市中西医结合医院,浙江温州325000

出　　处：《中华中医药学刊》2021年第2期185-188,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中医药科学研究基金(2017ZH065)。

摘　　要：目的研究活血解郁汤结合氟西汀对卒中后抑郁患者血清脑源性神经营养因子的影响。方法选择医院神经内科2017年3月—2019年5月收治的脑卒中后抑郁患者80例,按照就诊顺序分为对照组和治疗组各40例;对照组患者采用单纯氟西汀胶囊进行治疗。治疗组患者在对照组基础上联合活血解郁汤进行治疗。两组患者连续治疗30 d为1个疗程,共治疗4个疗程。比较两组患者治疗疗效、比较两组患者治疗前后血清BDNF、NGF、DA、5-HT及NE水平、比较两组患者治疗前后HAMD、NIHSS、MBI及ADL评分、比较两组患者治疗前后氨基酸类神经递质Glu、Asp、Gly、GABA水平、比较两组患者不良反应发生情况。结果经研究发现,治疗组治疗后血清BDNF、NGF、DA、5-HT及NE水平显著高于对照组(P<0.05)。治疗组治疗后HAMD、NIHSS评分显著低于对照组;MBI评分显著高于对照组(P<0.05)。治疗组治疗后氨基酸类神经递质Glu、Asp水平显著低于对照组;Gly、GABA水平显著高于对照组(P<0.05)。治疗组胃肠道反应、困倦乏力、口干、食欲减退及不安躁动总发生率82.50%(33/40),治疗组总发生率为27.50%(11/40),治疗组总发生率显著低于对照组(P<0.05)。结论总结得出,活血解郁汤结合氟西汀对脑卒中抑郁患者进行治疗,通过改善了患者血清BDNF、NGF、DA、5-HT及NE水平和氨基酸类神经递质Glu、Asp、Gly、GABA水平,降低了不良反应,提高了临床治疗疗效,值得进一步研究探讨。Objective To study the effect of Huoxue Jieyu(活血解郁汤)decoction combined with fluoxetine on serum brain-derived neurotrophic factors in patients with post-stroke depression.Methods Eighty patients with post-stroke depression admitted to neurology department of our hospital from March 2017 to may 2019 were divided into control group and treatment group according to the order of treatment,40 cases in each group.Patients in the control group were treated with Fluoxetine Capsule alone.The patients in the treatment group were treated with Huoxue Jieyu Decoction on the basis of the control group.Two groups treated for 30 days as a course of treatment,a total of 4 courses of treatment.The therapeutic effect of the two groups,the serum levels of BDNF,NGF,Da,5-HT and NE before and after treatment,the HAMD,NIHSS,MBI and ADL scores before and after treatment,the levels of amino acid neurotransmitter Glu,ASP,Gly and GABA before and after treatment were compared and the adverse reactions of the two groups were observed.Results After treatment,the levels of BDNF,NGF,Da,5-HT and NE in the treatment group were significantly higher than those in the control group(P<0.05).After treatment,HAMD and NIHSS scores in the treatment group were significantly lower than those in the control group,and MBI scores were significantly higher than those in the control group(P<0.05).The levels of Glu and ASP in the treatment group were significantly lower than those in the control group,and the levels of Gly and GABA were significantly higher than those in the control group(P<0.05).The total incidence of gastrointestinal reaction,drowsiness,dry mouth,anorexia and restlessness in the treatment group was 82.50%(33/40).The treatment group’s incidence 27.50%(11/40)was significantly lower than that in the control group(P<0.05).Conclusion It is concluded that Huoxue Jieyu decoction combined with fluoxetine can improve the levels of serum BDNF,NGF,Da,5-HT and NE and the levels of amino acid neurotransmitter Glu,ASP,Gly and GABA,reduce the adve

关 键 词：活血解郁汤 氟西汀 卒中后抑郁 血清脑源性神经营养因子 

分 类 号：R277.749.13[医药卫生—中医学]