疏肝理气养血方联合氢溴酸西酞普兰治疗卒中后失眠伴抑郁老年患者的疗效观察及对睡眠质量和神经递质的影响  

Effect of Shugan Liqi Yangxue Decoction in Combination with Citalopram Hydrobromide on Sleep Quality and Neurotransmitter in Elderly Patients with Insomnia After Stroke and Depression

作　　者：徐明超[1] 樊书领[1] 李尽义[1] 任应国[1] XU Ming-chao;FAN Shu-ling;LI Jin-yi;REN Ying-guo(Department of Neurological Rehabilitation,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院神经康复科,南阳473000

出　　处：《中国合理用药探索》2024年第1期98-103,共6页Chinese Journal of Rational Drug Use

摘　　要：目的:观察疏肝理气养血方联合氢溴酸西酞普兰治疗卒中后失眠伴抑郁老年患者的疗效及对睡眠质量和神经递质的影响。方法:选取2021年5月~2023年2月某院收治的114例卒中后失眠伴抑郁的老年患者为研究对象,采用随机数字表法分为对照组与观察组,每组57例。对照组给予氢溴酸西酞普兰片,观察组在对照组治疗基础上加用疏肝理气养血方。比较两组神经递质的水平[5-羟色胺(5-HT)、P物质(SP)、甘氨酸、γ-氨基丁酸],评估两组美国国立卫生院卒中量表(NIHSS)评分、匹兹堡睡眠质量指数(PSQI)评分、中医症状评分、汉密尔顿抑郁量表(HAMD)评分、日常生活能力(ADL)评分的差异。比较两组临床治疗总有效率并记录治疗期间两组不良反应的发生情况。结果:治疗后,两组患者5-HT、甘氨酸、γ-氨基丁酸均较治疗前升高,且观察组高于对照组(P<0.05);SP较治疗前降低,且观察组低于对照组(P<0.05);NIHSS评分、PSQI评分、HAMD评分、中医症状评分均较治疗前降低,且观察组PSQI评分、HAMD评分、中医症状评分低于对照组(P<0.05);ADL评分较治疗前升高,且观察组高于对照组(P<0.05)。治疗后,观察组临床治疗总有效率(91.23%)高于对照组(77.19%,P<0.05)。治疗期间两组患者不良反应总发生率比较无统计学差异。结论:疏肝理气养血方联合氢溴酸西酞普兰可有效改善卒中后失眠伴抑郁老年患者的抑郁和失眠症状,提高睡眠质量,调节神经递质的表达,提高临床疗效,且不增加不良反应的发生风险。Objective:To observe the efficacy and effects on sleep quality and neurotransmitters of Shugan Liqi Yangxue decoction combined with citalopram hydrobromide in the treatment of post-stroke insomnia with depression in elderly patients.Methods:A total of 114 elderly patients with post-stroke insomnia and depression admitted to a hospital from May 2021 to February 2023 were selected for the study.They were divided into the control group and the observation group using the randomized numerical table method,with 57 cases in each group.The control group received citalopram hydrobromide,and the observation group received Shugan Liqi Yangxue decoction in addition to citalopram hydrobromide.The levels of neurotransmitters[5-hydroxytryptamine(5-HT),substance P(SP),glycine,andγ-aminobutyric acid]were detected in both groups.Additionally,the National Institute of Health stroke scale(NIHSS)scores,Pittsburgh sleep quality index(PSQI)scores,traditional Chinese medicine(TCM)symptom scores,and Hamilton depression scale(HAMD)scores were assessed in both groups,activity of daily living scale(ADL)scores.The total effective rate of clinical treatment was compared between the two groups and the occurrence of adverse events during treatment was recorded for both groups.Results:After treatment,5-HT,glycine andγ-aminobutyric acid were higher in both groups compared with before treatment.Additionally,the levels of each index in the observation group was higher than that in the control group(P<0.05);the SP of both groups were lower than before treatment,and the observation group was lower than the control group(P<0.05);the NIHSS score,PSQI score,HAMD score,and TCM symptom score of both groups were lower than before treatment,and the PSQI score,HAMD score,and TCM symptom score of the observation group were lower than those of the control group(P<0.05);the ADL scores of both groups were higher than before treatment,and the observation group was higher than the control group(P<0.05).After treatment,the total effective rate of clinical treatm

关 键 词：疏肝理气养血方 氢溴酸西酞普兰 抑郁 卒中 失眠 神经递质 

分 类 号：R743.3[医药卫生—神经病学与精神病学]