文拉法辛联合甜梦胶囊治疗脑梗死后焦虑抑郁对照研究  

A controlled study of venlafaxine combined with Tianmeng capsule in the treatment of anxiety and depression after cerebral infarction

作　　者：刘俊超[1] 张娜[1] Liu Junchao;Zhang Na(The Second Affiliated Hospital of Luohe Medical College,Luohe 462300,Henan,China)

机构地区：[1]漯河医学高等专科学校第二附属医院,河南漯河462300

出　　处：《临床心身疾病杂志》2021年第6期22-26,35,共6页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨文拉法辛联合甜梦胶囊治疗脑梗死后焦虑抑郁的临床疗效,及对患者躯体化症状、神经递质及睡眠质量的影响。方法将118例脑梗死后焦虑抑郁患者按1:1配对随机化原则分为观察组(59例)、对照组(59例)。对照组给予文拉法辛治疗,观察组在对照组基础上联合甜梦胶囊治疗,观察6周。比较两组临床疗效,比较治疗前后焦虑自评量表、抑郁自评量表、躯体化症状情况、匹兹堡睡眠质量指数评分及血清神经递质(5-羟色胺、多巴胺、去甲肾上腺素、孤啡肽)水平,统计不良反应发生率。结果观察组总有效率显著高于对照组(P<0.05)。治疗3周、6周末两组焦虑自评量表、抑郁自评量表、躯体化症状情况评分均较治疗前显著降低(P<0.01),5-羟色胺、多巴胺、去甲肾上腺素水平均较治疗前显著升高(P<0.01),孤啡肽水平较治疗前显著降低(P<0.01),组间比较差异有统计学意义(P<0.01)。治疗6周末两组匹兹堡睡眠质量指数总分及各维度分均较治疗前显著降低(P<0.01),观察组显著低于对照组(P<0.01)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论文拉法辛联合甜梦胶囊治疗脑梗死后焦虑抑郁疗效显著,可减轻焦虑抑郁情绪及躯体化症状,调节神经递质水平,改善睡眠质量,安全性高。Objective To explore the efficacy of venlafaxine combined with Tianmeng capsule in the treatment of anxiety and depression after cerebral infarction,and its effect on somatization symptoms,neurotransmitters and sleep quality.Methods A total of 118 patients with anxiety and depression after cerebral infarction were divided into observation group(59 cases)and control group(59 cases)according to the principle of randomization with the ratio of 1:1.The control group was treated with venlafaxine,and the observation group was treated with Tianmeng capsule on this basis.The clinical efficacy of the two groups was compared,the self-rating anxiety scale(SAS),self-rating depression scale(SDS),somatization symptoms,Pittsburge sleep quility index(PSQI)score and serum neurotransmitter levels[5-hydroxytryptamine(5-HT),dopamine(DA),norepinephrine(NE),orphanin FQ(OFQ)]were compared before and after treatment,and the incidence of adverse reactions was calculated.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).The scores of SAS,SDS and somatization symptoms in the two groups were significantly lower than those before treatment(P<0.01),5-HT,DA,NE were significantly higher than those before treatment(P<0.01),OFQ level was significantly lower than that before treatment(P<0.01),and the difference between the groups was statistically significant(P<0.01).AfteR6 weeks of treatment,the total score of PSQI and the scores of all dimensions in both groups were significantly lower than those before treatment(P<0.01),and the observation group was[JP+3]significantly lower than the control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups ( P >0.05). Conclusions Venlafaxine combined with Tianmeng capsule has significant curative effect in the treatment of anxiety and depression after cerebral infarction, which can reduce anxiety, depression and somatization symptoms, regulate the level of neurotransmitters, improve sleep quali

关 键 词：脑梗死 焦虑 抑郁 甜梦胶囊 文拉法辛 神经递质 睡眠质量 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]