解郁安神方治疗卒中后抑郁的疗效及对患者睡眠质量的影响  

Effect of Jieyu Anshen formula on post-stroke depression and sleep quality

作　　者：陈永新[1] 涂荣蓉 韩亚琼[1] 张瑞岭[2] CHEN Yongxin;TU Rongrong;HAN Yaqiong;ZHANG Ruiling(Department of Pharmacy,the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453002,China;Department of Mood Disorders,the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453002,China;Emergency Department of Henan Rongjun Hospital,Xinxiang,Henan 453002,China)

机构地区：[1]新乡医学院第二附属医院药学部,河南省新乡市453002 [2]新乡医学院第二附属医院精神科,河南省新乡市453002 [3]河南省荣军医院急诊科,河南省新乡市453002

出　　处：《中南医学科学杂志》2021年第2期192-196,共5页Medical Science Journal of Central South China

基　　金：河南省卫生计生科技创新型人才“51282”工程;河南省高校科技创新团队支持计划(17IRTSTHN023)。

摘　　要：目的探讨解郁安神方治疗卒中后抑郁(PSD)的疗效及对患者睡眠质量的影响。方法将96例PSD患者按入院顺序随机分为对照组和观察组各48例。两组患者均给予常规康复治疗。对照组常规康复治疗基础上给予米氮平治疗,观察组常规康复治疗基础上给予解郁安神方治疗。按照《中医症候疗效判断标准》评定疗效,治疗前后以汉密尔顿抑郁量表(HAMD)评分、脑卒中影响量表(SIS)评分、简易精神状态检查量表(MMSE)评分以及匹兹堡睡眠质量指数(PSQI)量表评定抑郁、脑损伤、生存质量以及睡眠质量。并采用酶联免疫吸附法检测两组患者的5-羟色胺(5-HT)、神经肽Y(NPY)以及下丘脑外侧区分泌素(hypocretin)含量。结果观察组患者总有效率(91.67%)明显高于对照组(79.17%;P<0.05)。与治疗前比较,两组患者治疗后的HAMD评分、CSS、PSQI量表各项指标评分、PSQI总评分以及hypocretin水平均较治疗前明显降低,SIS评分和MMSE评分以及5-HT、NPY水平均较治疗前明显升高(P<0.05);两组间比较差异均具有显著性(P<0.05)。结论解郁安神方治疗PSD效果良好,可有效改善患者抑郁状态和认知能力,降低脑损伤和hypocretin水平,提升5-HT、NPY水平,提高患者睡眠质量及生存质量。Aim To explore the effect of Jieyu Anshen formula on poststroke depression(PSD)and its effect on sleep quality.Methods 96 cases of PSD were randomly divided into control group and observation group,48 cases in each group.The control group was treated with routine rehabilitation and mirtazapine,while the observation group was treated with routine rehabilitation and Jieyu Anshen Decoction.The curative effect,HAMD score,SIS score,MMSE score and PSQI score before and after treatment were compared between the two groups.The levels of 5-HT,NPY and hypocretin were detected with ELISA.Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).HAMD score,CSS,PSQI sub-score,PSQI total score and hypocretin level of the two groups after treatment were significantly lower than those before treatment,SIS score,MMSE score and 5-HT,NPY level of the two groups were significantly higher than those before treatment(P<0.05);there were significant differences between the two groups(P<0.05).Conclusion Jieyu Anshen formula has good effect in the treatment of PSD,which can effectively alleviate depression symptoms and improve cognitive ability of patients,reduce brain injury and hypocretin levels,improve 5-HT and NPY levels,and improve sleep quality and life quality of patients.

关 键 词：解郁安神方 卒中后抑郁 睡眠质量 5-羟色胺 神经肽Y 下丘脑外侧区分泌素 

分 类 号：R749.1[医药卫生—神经病学与精神病学]