柴胡加龙骨牡蛎汤联合艾司西酞普兰对卒中后抑郁患者神经功能、抑郁状态和血清脑源性神经营养因子、5-羟色胺水平的影响  

Effects of Chaihu Longgu Muli Decoction combined with Escitalopram on neurological function,depressive state and serum levels of brain-derived neurotrophic factor,5-hydroxytryptamine in patients with post-stroke depression

作　　者：凌志香[1] 张兰坤[1] 刘元月 LING Zhixiang;ZHANG Lankun;LIU Yuanyue(Department of Encephalopathy,The Second Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210017)

机构地区：[1]南京中医药大学第二附属医院脑病科,江苏南京210017

出　　处：《河北中医》2024年第9期1472-1474,1479,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：南京中医药大学第二附属医院(江苏省第二中医院)院内项目(编号:SEZJY2023001)。

摘　　要：目的观察柴胡加龙骨牡蛎汤联合艾司西酞普兰对卒中后抑郁(PSD)患者神经功能、抑郁状态及血清脑源性神经营养因子(BDNF)、5-羟色胺(5-HT)水平的影响。方法将98例PSD患者按照随机数字表法分为治疗组和对照组,各49例。对照组予草酸艾司西酞普兰片治疗6周,治疗组在对照组治疗基础上加柴胡加龙骨牡蛎汤治疗6周。比较2组疗效及治疗前、治疗3周和治疗6周美国国立卫生研究院卒中量表(NIHSS)评分和血清5-HT、BDNF水平。结果治疗组总有效率87.76%(43/49),对照组总有效率69.39%(34/49),治疗组总有效率高于对照组(P<0.05)。2组治疗3、6周NIHSS、HAMD评分均显著低于本组治疗前(P<0.05),治疗6周NIHSS和HAMD评分均显著低于本组治疗3周(P<0.05);治疗3、6周治疗组NIHSS和HAMD评分均显著低于对照组同期(P<0.05)。2组治疗3、6周5-HT、BDN水平均显著高于本组治疗前(P<0.05),治疗6周5-HT、BDNF水平均显著高于本组治疗3周(P<0.05);治疗3、6周治疗组5-HT和BDNF水平显著高于对照组同期(P<0.05)。结论柴胡加龙骨牡蛎汤联合艾司西酞普兰能改善PSD抑郁状态、神经功能及血清BDNF、5-HT水平。Objective To analyze the effects of Chaihu Longgu Muli Decoction combined with Escitalopram on the neurological function,depressive state and serum levels of brain-derived neurotrophic factor(BDNF)and 5-hydroxytryptamine(5-HT)in patients with post-stroke depression(PSD).Methods A total of 98 patients with PSD were recruited in this study,and they were assigned in a 1∶1 ratio to Escitalopram(control group)or Chaihu Longgu Muli Decoction plus Escitalopram(study group)by a random number table for 6 weeks.National Institutes of Health Stroke Scale(NIHSS),serum BDNF and 5-HT levels on day 0,and at weeks 3 and 6 in the both groups were compared.The clinical efficacy was assessed.Results After treatment,the total effective rate was obviously higher in the study group than in the control group(87.76%[43/49]vs 69.39%[34/49],P<0.05).NIHSS and Hamilton depression scale(HAMD)scores at weeks 3 and 6 in the both groups were obviously lower than those on day 0(P<0.05),and with significant inter-group differences(P<0.05).NIHSS and HAMD scores at week 6 in the both groups were obviously lower than those at week 3(P<0.05).The serum levels of 5-HT and BDNF at weeks 3 and 6 in the both groups were obviously higher than those on day 0(P<0.05),which were obviously higher in the study group than in the control group(P<0.05).The serum levels of 5-HT and BDNF at week 6 in the both groups were obviously higher than those at week 3(P<0.05).Conclusion The combination of Chaihu Longgu Muli Decoction and Escitalopram has a good effect in treating PSD patients,it can improve depressive state,and neurological function,and serum BDNF and 5-HT levels.

关 键 词：卒中 抑郁 中西医结合疗法 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.420.58[医药卫生—临床医学]