盐酸舍曲林联合腹部按摩治疗脑卒中后抑郁的临床疗效  

Clinical efficacy of sertraline hydrochloride combined with abdominal massage on poststroke depression

作　　者：吴志敏[1] 金永喜[1] 胡万华[1] 赵娜[1] WU Zhimin;JIN Yongxi;HU Wanhua;ZHAO Na(Department of Neurology,Wenzhou Hospital of Traditional Chinese Medicine in Zhejiang Province,Wenzhou325000,China)

机构地区：[1]浙江省温州市中医院神经内科,浙江温州325000

出　　处：《中国现代医生》2021年第10期92-95,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2017ZB087)。

摘　　要：目的基于脑肠轴理论探讨盐酸舍曲林联合腹部按摩治疗脑卒中后抑郁(PSD)的临床疗效及作用机制。方法研究对象为2018年12月至2019年12月在温州市中医院神经内科住院的80例卒中后抑郁(PSD)患者,随机分成试验组和对照组,每组各40例。两组患者均进行常规盐酸舍曲林治疗,试验组加用腹部按摩治疗。治疗后观察两组临床疗效并进行比较;分别采用汉密尔顿抑郁量表(HAMD)、中国卒中量表(CSS)对PSD患者抑郁情况及神经功能缺损情况进行评价,两组患者治疗前、治疗4周后分别评价1次;治疗前、治疗4周后检测患者血清中5-羟色胺(5-HT)、胃泌素(GAS)水平。结果试验组患者治疗的总有效率为91.43%,对照组的总有效率77.78%,差异有统计学意义(P<0.05)。治疗4周后,试验组HAMD、CSS评分均低于对照组,差异均有统计学意义(P<0.05)。两组患者5-HT和GAS水平均比治疗前明显提高,差异均有统计学意义(P<0.05),且试验组治疗后5-HT和GAS数值均高于对照组(P<0.05)。结论盐酸舍曲林联合腹部按摩治疗PSD的临床疗效显著,可能与提高5-HT、GAS等客观指标的表达有关。Objective To investigate the clinical efficacy and mechanism of sertraline hydrochloride combined with abdominal massage on poststroke depression(PSD)based on brain-gut axis theory.Methods A total of 80 PSD patients admitted to the department of neurology,Wenzhou Hospital of Traditional Chinese Medicine from December 2018 to December 2019 were selected as the research objects,and they were randomly divided into the experimental group(n=40)and the control group(n=40).Both groups were treated with conventional sertraline hydrochloride,while treatment of the experimental group was combined with abdominal massage.After treatment,the clinical efficacies of the two groups were observed and compared.Hamilton depression scale(HAMD)and Chinese stroke scale(CSS)were respectively applied to evaluate the depression and neurological deficit of PSD patients,and the two groups were respectively evaluated once before treatment and 4 weeks after treatment.Serum levels of 5-hydroxytryptamine(5-HT)and gastrin(GAS)were measured before and 4 weeks after treatment.Results The total efficacy rate was 91.43%in the experimental group and 77.78%in the control group,with a statistically significant difference(P<0.05).After 4 weeks of treatment,the scores of HAMD and CSS in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of 5-HT and GAS in both groups were significantly higher than those before treatment(P<0.05),and the values of 5-HT and GAS in the experimental group were higher than those in the control group after treatment(P<0.05).Conclusion Sertraline hydrochloride combined with abdominal massage are effective in treating PSD patients,which may be related to improving the expression of objective indexes such as 5-HT and GAS.

关 键 词：盐酸舍曲林 腹部按摩 脑肠轴 脑卒中后抑郁 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]