活血通络方联合重复经颅磁刺激对脑卒中后抑郁患者抑郁症状及神经递质水平的影响  

Effect of Huoxue Tongluo Prescription Combined with Repetitive Transcranial Magnetic Stimulation on Depressive Symptoms and Neurotransmitter Levels in Patients with Post-stroke Depression

作　　者：李花[1] 田苗[2] 许济 陶黎[1] 梁勇 雷琦[3] Li Hua;Tian Miao;Xu Ji;Tao Li;Liang Yong;Lei Qi(Department of Neurology,3201 Hospital Affiliated to Medical College of Xi'an Jiaotong University,Xi'an,Shanxi 723000;Department of rehabilitation medicine,3201 Hospital Affiliated to Medical College of Xi'an Jiaotong University,Xi'an,Shanxi 723000;Department of Neurology,Shaanxi Provincial People's Hospital,Xi'an,Shanxi 710068)

机构地区：[1]西安交通大学医学院附属三二○一医院神经内科,723000 [2]西安交通大学医学院附属三二○一医院康复医学科,723000 [3]陕西省人民医院神经内二科,710068

出　　处：《中药药理与临床》2021年第3期176-180,共5页Pharmacology and Clinics of Chinese Materia Medica

基　　金：陕西省重点研发计划(编号:2017SF-289)。

摘　　要：目的:分析活血通络方联合重复经颅磁刺激对脑卒中后抑郁患者抑郁症状及神经递质水平的影响,为脑卒中后抑郁患者的临床治疗提供参考。方法:选取2018年6月到2020年5月我院脑卒中后抑郁患者136例,采用随机数字表法将其分为对照组和观察组,每组各68例。对照组在常规治疗基础上进行重复经颅磁刺激治疗,观察组在常规治疗基础上进行活血通络方联合重复经颅磁刺激治疗。比较两组患者的临床疗效、症状严重程度、心理状态、活动能力、神经递质水平及不良反应情况。结果:治疗后,两组Barthel指数(BI)评分较治疗前明显升高,两组抑郁自评量表(SDS)、美国国立卫生研究院卒中量表(NHISS)及汉密顿抑郁量表(HAMD)评分及中医症状评分较治疗前均明显降低(P<0.05),两组去甲肾上腺素(NE)、5-羟色胺(5-HT)、多巴胺(DA)、脑源性神经营养因子(BDNF)水平较治疗前均明显升高(P<0.05),神经元烯醇化酶(NSE)水平较治疗前明显降低(P<0.05)。与对照组比较,治疗后,观察组总有效率明显增高(P<0.05),Barthel指数(BI)评分明显升高,抑郁自评量表(SDS)、美国国立卫生研究院卒中量表(NHISS)及汉密顿抑郁量表(HAMD)评分及中医症状评分明显降低(P<0.05),NE、BDNF、DA、5-HT水平明显升高(P<0.05),NSE水平明显降低(P<0.05);治疗组不良反应发生率明显低于对照组(P<0.05)。结论:采用活血通络方联合重复经颅磁刺激治疗脑卒中后抑郁患者可有效减轻患者临床症状,缓解患者抑郁情绪,提高患者活动能力,改善神经递质水平,具有显著的临床疗效和良好的安全性。Objective:To analyze the effect of Huoxue Tongluo Prescription combined with repetitive transcranial magnetic stimulation on depressive symptoms and neurotransmitter levels in patients with post-stroke depression,in order to provide reference for clinical treatment of patients with post-stroke depression.Methods:136 patients with post-stroke depression in our hospital from June 2018 to May 2020 were selected and divided into the control group and the observation group by the random number table method,68 cases in each group.The patients in the control group received repetitive transcranial magnetic stimulation combined with the conventional treatment,while those in the observation group received repetitive transcranial magnetic stimulation combined with Huoxue Tongluo Prescription and the conventional treatment.The clinical efficacy,the severity of symptoms,the mental state,the activity ability,the neurotransmitter levels and the adverse reactions were compared between the two groups.Results:After treatment,the Barthel Index(BI)scores in the two groups were obviously higher than those before treatment,while the scores of self rating Depression Scale(SDS),National Institutes of Health Stroke Scale(NHISS),Hamilton Depression scale(HAMD)and Traditional Chinese Medicine(TCM)syndrom in the two groups were obviously lower than those before treatment(P<0.05),the levels of monoamine neurotransmitters norepinephrine(NE),5-hydroxytryptamine(5-HT),dopamine(DA)and brain-derived neurotrophic factor(BDNF)in the two groups were obviously higher than those before treatment,the levels of neuron enolase(NSE)in the two groups were obviously lower than those before treatment(P<0.05).Compared with the control group,after treatment,the total effective rate was significantly increased in the observation group(P<0.05),the BI score was significantly increased,the scores of SDS,NHISS,HAMD and TCM symptom were decreased(P<0.05),the levels of NE,BDNF,DA and 5-HT in the observation group were significantly increased(P<0.05),the level of NSE

关 键 词：活血通络方 重复经颅磁刺激 脑卒中后抑郁 神经递质水平 抑郁症状 

分 类 号：R277.7[医药卫生—中医学]