越鞠升降汤联合帕罗西汀治疗肝气郁结型卒中后抑郁的临床疗效  

Clinical effect of Yuejushengjiang decoction combined with paroxetine in the treatment of post-stroke depression of liver Qi stagnation type

作　　者：阮甦[1] 倪财锋[2] 林昱[1] RUAN Su;NI Caifeng;LIN Yu(People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350004,China;不详)

机构地区：[1]福建中医药大学附属人民医院,福建省福州市350004 [2]福建师范大学医院,福建省福州市350007

出　　处：《临床合理用药杂志》2022年第33期18-20,25,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨越鞠升降汤联合帕罗西汀治疗肝气郁结型卒中后抑郁的临床疗效。方法选取福建中医药大学附属人民医院2020年2月—2021年10月收治的肝气郁结型卒中后抑郁患者84例,采用随机数字表法分为对照组和观察组,各42例。对照组患者采用抗血小板聚集药物及帕罗西汀治疗,观察组患者在对照组治疗基础上联合越鞠升降汤治疗,2组均连续治疗8周。比较2组治疗效果,治疗前及治疗2、4、6、8周后汉密尔顿抑郁量表(HAMD)评分,治疗前及治疗8周后中医症状积分、负性自动思维问卷(ATQ)相信程度评分、ATQ频繁程度评分,不良反应。结果观察组治疗总有效率为97.62%,高于对照组的80.95%(χ^(2)=4.480,P=0.034)。与治疗前相比,2组治疗2、4、6、8周后HAMD评分降低(P<0.05);观察组治疗4、6、8周后HAMD评分低于对照组(P<0.05)。与治疗前相比,2组治疗8周后中医症状积分及ATQ相信程度评分、ATQ频繁程度评分降低(P<0.05);且观察组治疗8周后中医症状积分及ATQ相信程度评分、ATQ频繁程度评分低于对照组(P<0.01)。观察组不良反应总发生率为4.76%,低于对照组的21.42%(χ^(2)=5.125,P=0.023)。结论越鞠升降汤联合帕罗西汀治疗肝气郁结型卒中后抑郁能够增强疗效,改善症状,缓解患者抑郁情绪,降低负性自动思维发生频率,且可减少药物不良反应,安全性较高。Objective To explore the clinical effect of Yuejushengjiang decoction combined with paroxetine in the treatment of post-stroke depression of liver Qi stagnation type.Methods A total of 84 patients with post-stroke depression diagnosed as liver Qi stagnation from February 2020 to October 2021 in People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,and they were divided into the control group and the observation group according to random number table method,42 cases in each group.The control group was treated with antiplatelet aggregation drugs and paroxetine therapy,and the observation group was treated with Yuejushengjiang decoction on the basis of the control group,both groups were treated for 8 weeks.Clinical effect,HAMD score before treatment and at 2,4,6,8 weeks after treatment,score of TCM symptom,ATQ belief and ATQ frequency before treatment and at 8 weeks after treatment,incidence of adverse reactions were compared between the two groups.Results Total effective rate in the observation group was 97.62%,which was higher than 80.95%of control group(χ^(2)=4.480,P=0.034).Compared with HAMD score before treatment,HAMD score at 2,4,6,8 weeks after treatment in the two groups was decreased(P<0.05);HAMD score at 4,6,8 weeks after treatment in the observation group was lower than that in the control group(P<0.05).Compared with those before treatment,score of TCM symptom,ATQ belief and ATQ frequency at 8 weeks after treatment in the two groups were decreased(P<0.05);and score of TCM symptom,ATQ belief and ATQ frequency at 8 weeks after treatment in the observation group were lower than those in the control group(P<0.01).Incidence of adverser reactions in the observation group was 4.76%,which was lower than 21.42%of control group(χ^(2)=5.125,P=0.023).Conclusion Yuejushengjiang decoction+paroxetine can enhance curative effect in the treatment of post-stroke depression of liver Qi stagnation type,and can improve symptoms,relieve depression of patients,reduce the frequency of negative aut

关 键 词：卒中 卒中后抑郁 越鞠升降汤 盐酸帕罗西汀片 治疗结果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]