颐脑解郁方联合五行音乐对轻中度卒中后抑郁患者血清5-HT、NE的影响研究  

Effect of Yinao Jieyu Prescription Combined with Five-Element Music Therapy on Serum 5-Hydroxytryptamine and Norepinephrine in Patients with Mild-to-Moderate Post-Stroke Depression

作　　者：李玮[1] 张慧和 朱政羽 赵娜[1] LI Wei;ZHANG Hui-He;ZHU Zheng-Yu;ZHAO Na(Wenzhou Hospital of Traditional Chinese Medicine,Wenzhou 325000 Zhejiang,China)

机构地区：[1]浙江省温州市中医院,浙江温州325000

出　　处：《广州中医药大学学报》2023年第4期826-832,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：浙江省温州市基础性科研项目(编号:Y2020888)。

摘　　要：【目的】探讨颐脑解郁方联合五行音乐对轻中度卒中后抑郁(PSD)患者的治疗效果及对血清5-羟色胺(5-HT)、去甲肾上腺素(NE)的作用。【方法】将120例轻中度PSD患者随机分为西药组、颐脑解郁方组、五行音乐组、联合组4组,每组各30例,各组患者在常规脑卒中康复治疗基础上,分别给予盐酸氟西汀胶囊、颐脑解郁方、五行音乐、颐脑解郁汤联合五行音乐治疗,疗程为4周。观察各组患者治疗前后汉密尔顿抑郁量表(HAMD)评分、美国国立卫生研究院卒中量表(NIHSS)神经功能评分、改良Rankin量表(mRS)评分、Barthel指数(BI)评分及血清5-HT、NE水平的变化情况,并评价各组患者的临床疗效。【结果】(1)治疗4周后,西药组、五行音乐组、颐脑解郁方组、联合组的总有效率分别为86.67%(26/30)、76.67%(23/30)、73.33%(22/30)、93.33%(28/30);组间比较,联合组的总体疗效优于其他3组(P<0.05),西药组优于五行音乐组和颐脑解郁方组(P<0.05),而五行音乐组与颐脑解郁方组比较,差异无统计学意义(P>0.05)。(2)治疗后,各组患者的HAMD评分、NIHSS评分、m RS评分和BI评分均较治疗前明显改善(P<0.05);组间比较,联合组对各项量表评分的改善作用优于其他3组,西药组优于五行音乐组和颐脑解郁方组,五行音乐组又优于颐脑解郁方组,差异均有统计学意义(P<0.05)。(3)治疗后,各组患者血清5-HT、NE水平均较治疗前明显升高(P<0.05);组间比较,联合组的血清5-HT、NE水平高于其他3组,西药组高于五行音乐组和颐脑解郁方组,五行音乐组又高于颐脑解郁方组,差异均有统计学意义(P<0.05)。【结论】颐脑解郁方联合五行音乐疗法治疗轻中度PSD患者疗效确切,可有效调控血清5-HT、NE水平,改善患者抑郁症状,促进患者神经功能恢复,改善患者预后,提高患者生活质量。Objective To investigate the therapeutic effects of Yinao Jieyu Prescription combined with five-element music therapy on patients with mild-to-moderate post-stroke depression(PSD)and to observe its effects on serum5-hydroxytryptamine(5-HT)and norepinephrine(NE)of the patients. Methods A total of 120 patients with mildto-moderate PSD were randomly divided into 4 groups,namely western medicine group,Yinao Jieyu Prescription group,five-element music therapy group and combination group,with 30 patients in each group. The patients in each group were respectively given Fluoxetine Hydrochloride Capsules,Yinao Jieyu Prescription,five-element music therapy, and Yinao Jieyu Prescription combined with five-element music therapy on the basis of conventional rehabilitation treatment for stroke. The treatment for the 4 groups lasted for 4 weeks. The changes in Hamilton Depression Scale(HAMD)scores,neurological function scores of National Institutes of Health Stroke Scale(NIHSS),modified Rankin Scale(m RS)scores,Barthel Index(BI)scores and serum 5-HT and NE levels in each group were observed before and after treatment,and the clinical efficacy of each group was evaluated after treatment. Results(1)After 4 weeks of treatment,the overall effective rate of the western medicine group,fiveelement music therapy group, Yinao Jieyu Prescription group and combination group was 86.67%(26/30),76.67%(23/30),73.33%(22/30)and 93.33%(28/30),respectively. The intergroup comparison showed that the overall efficacy of the combination group was supeiror to that of the other three groups(P<0.05),and the western medicine group was superior to the five-element music therapy and Yinao Jieyu Prescription group(P<0.05).There was no statistical significance between the five-element music therapy and Yinao Jieyu Prescription group(P>0.05).(2)After treatment,the HAMD scores,NIHSS scores,mRS scores and BI scores in all of the 4 groups were significantly improved compared with those before treatment(P<0.05). The intergroup comparison showed that the combina

关 键 词：卒中后抑郁 颐脑解郁方 五行音乐 神经功能 生活质量 5-羟色胺(5-HT) 去甲肾上腺素(NE) 

分 类 号：R277.7[医药卫生—中医学]