益气解郁活血方联合盐酸文拉法新片治疗脑卒中后抑郁症临床研究  

Clinical Study on Decoction for Replenishing Qi and Relieving Depression and Activating Blood Combined with Venlafaxine in the Treatment of Post-Stroke Depression

作　　者：崔明浩 CUI Minghao(Zhenping County Hospital of Traditional Chinese Medicine,Zhenping,Henan,China,474250)

机构地区：[1]镇平县中医院,河南镇平474250

出　　处：《河南中医》2024年第1期81-86,共6页Henan Traditional Chinese Medicine

摘　　要：目的:观察益气解郁活血方联合盐酸文拉法新片治疗脑卒中后抑郁症的临床疗效。方法:将88例脑卒中后抑郁症患者按照随机数字表法分为治疗组和对照组,每组各44例。两组患者均给予常规基础治疗,对照组给予盐酸文拉法新片治疗,治疗组在对照组治疗的基础上加用益气解郁活血方治疗。比较两组患者的临床疗效及治疗前后汉密尔顿抑郁症量表评分(hamilton depression scale,HAMD)、美国国立卫生院神经功能缺损评分(national institutes of health neurological deficit score,NIHSS)变化情况;检测两组患者治疗前后炎性因子水平[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin,IL-6)、超敏C反应蛋白(hypersensitive C reactive protein,hs-CRP)]、血清神经递质水平[5-羟色胺(5-hydroxytryptamine,5-HT)、多巴胺(dopamine,DA)、神经生长因子(nerve growth factor,NGF)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)]及血清神经功能因子水平[中枢神经特异蛋白(S100 calcium binding protein β,S100β)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)、髓鞘碱性蛋白(myelin basic protein,MBP)]。结果:治疗组有效率为88.64%,对照组有效率为70.45%,两组有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后TNF-α、IL-6、hs-CRP、S100β蛋白、NSE、MBP低于本组治疗前,且治疗后治疗组低于对照组(P<0.05)。两组患者治疗后5-HT、DA、NGF、BDNF等神经递质水平高于本组治疗前,且治疗后治疗组高于对照组(P<0.05)。两组患者治疗后NIHSS、HAMD评分均低于本组治疗前,且治疗后治疗组低于对照组(P<0.05)。结论:益气解郁活血方联合盐酸文拉法新片治疗脑卒中后抑郁症,可降低患者血清神经功能因子水平及炎性因子水平,提高血清神经递质水平,改善神经功能缺损情况,减轻患者抑郁症状态。Objective:To observe the clinical efficacy of Decoction for Replenishing Qi and Relieving Depression and Activating Blood combined with Venlafaxine in the treatment of post-stroke depression.Methods:A total of 88 patients with post-stroke depression were divided into the treatment group and the control group according to the random number table method,with 44 cases in each group.Both groups were first given conventional basic treatment,then the control group was additionally given Venlafaxine,while the treatment group was added with Decoction for Replenishing Qi and Relieving Depression and Activating Blood on the basis of the treatment of the control group.The clinical efficacy,the changes in Hamilton Depression Scale(HAMD) and National Institutes of Health neurological deficit score(NIHSS) of the two groups before and after treatment were compared.The levels of inflammatory factors [including tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),hypersensitive-C-reactive-protein(hs-CRP)],serum neurotransmitters [5-hydroxytryptamine(5-HT),dopamine(DA),nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF)],serum neurofunctional factors [including central nervous specific protein S100 calcium binding protein β(S100β),neuron-specific enolase(NSE),myelin basic protein(MBP)] were detected before and after treatment.Results:The effective rate of the treatment group was 88.64%,while that of the control group was 70.45%,with a statistically significant difference(P<0.05).After treatment,the levels of TNF-α,IL-6,hs-CRP,S100β protein,NSE and MBP in the two groups were lower than those before treatment,and the treatment group′s above indexes were lower than those of the control group(P<0.05);The levels of 5-HT,DA,NGF,BDNF and other neurotransmitters in the two groups were higher than those before treatment,and the treatment group′s above levels were higher than those of the control group(P<0.05);The NIHSS and HAMD scores in the two groups were lower than those before treatment,and the treatment group′s

关 键 词：脑卒中后抑郁症 益气解郁活血方 盐酸文拉法新片 中西医结合疗法 

分 类 号：R277.7[医药卫生—中医学]