丹栀逍遥散联合针刺治疗卒中后抑郁  

Therapeutic effect of Danzhi Xiaoyao Powder combined with acupuncture in the treatment of post-stroke depression

作　　者：马腾[1] 张持萍 徐伟文 MA Teng;ZHANG Chiping;XU Weiwen(Rehabilitation Medicine Department of Jiangsu ProvinceHospital/Suqian First Hospital,Suqian 223800,China;Traditional Chinese Medicine Department of Nanjing Drum Tower Hospital Group Suqian Hospital/Xuzhou Medical University Affiliated Suqian Hospital,Suqian 223800,China)

机构地区：[1]江苏省人民医院宿迁医院/宿迁市第一人民医院康复医学科,江苏宿迁223800 [2]南京鼓楼医院集团宿迁医院/徐州医科大学附属宿迁医院中医科,江苏宿迁223800

出　　处：《吉林中医药》2025年第1期64-68,共5页Jilin Journal of Chinese Medicine

基　　金：国家卫生健康委“十四五”规划全国重点课题计划项目(YYWS5661)。

摘　　要：目的探讨丹栀逍遥散联合针刺治疗卒中后抑郁(post-stroke depression,PSD)的临床疗效及对患者脑血管血流速度、抑郁症状、神经递质水平的影响。方法选择卒中后抑郁患者108例,随机分为对照组与观察组,各54例。2组均给予卒中内科基础治疗,指导患者进行适当康复训练。在此基础上,对照组采用草酸艾司西酞普兰片治疗,观察组在对照组基础上予丹栀逍遥散联合针刺治疗。2组均持续治疗4周。比较2组治疗4周后临床疗效结果,治疗前、治疗2周、4周后中医证候评分、抑郁症状,治疗前、治疗4周后脑血管血流速度及神经递质水平。结果治疗4周后,观察组临床疗效结果总有效率(94.44%,51/54)高于对照组(79.63%,43/54)(P<0.05)。治疗4周后,2组中医证候评分及汉密尔顿抑郁量表(HAMD)评分均低于治疗前、治疗2周后,治疗2周后低于治疗前,且治疗2周、4周后,观察组低于对照组(P<0.05)。与治疗前比较,治疗4周后,2组脑血管血流速度、血清去甲肾上腺素(NE)、多巴胺(DA)、肾上腺素(E)水平均升高,观察组高于对照组(P<0.05)。结论丹栀逍遥散联合针刺治疗卒中后抑郁患者,能够缓解抑郁症状及相关症状,改善患者脑血管血流速度、神经递质,提高临床疗效。Objective To explore the therapeutic effect of Danzhi Xiaoyao Powder combined with acupuncture in the treatment of post-stroke depression(PSD)and its impact on the cerebrovascular blood flow velocity,depression symptoms,and levels of neurotransmitters in patients.Methods The research subjects were selected from patients with PSD who received treatment at the Jiangsu Province(Suqian)Hospital.A total of 108 cases were included and randomly divided into a control group and an observation group,with 54 cases in each group.Oxalate escitalopram tablets were used to treat the patients in the control group,while the patients in the observation group were given Danzhi Xiaoyao Powder combined with an acupuncture treatment on the basis of the control group.Both groups were treated continuously for 4 weeks.The clinical efficacy of the two groups after 4 weeks of treatment,scores of traditional Chinese medicine syndromes,depression symptoms before treatment,two and four weeks after treatment,cerebrovascular blood flow velocity,and levels of neurotransmitters before treatment and 4 weeks after treatment of the two groups were compared.Results After 4 weeks of treatment,the total effective rate was higher in the observation group(94.44%,51/54)than that in the control group(79.63%,43/54)(P<0.05).After 4 weeks of treatment,the TCM syndrome scores and Hamilton Depression Scale(HAMD)scores were lower in both groups than those before treatment and after 2 weeks of treatment,and they were lower after 2 weeks of treatment than before treatment,and the scores in the observation group was lower after 2 and 4 weeks of treatment than those in the control group(P<0.05).Compared with before treatment,the cerebral blood flow velocity and the levels of serum norepinephrine(NE),dopamine(DA),adrenaline(E)were increased in both groups after 4 weeks of treatment,and the observation group was higher than the control group(P<0.05).Conclusion Danzhi Xiaoyao Powder combined with acupuncture treatment can effectively alleviate depression symptoms and

关 键 词：卒中 抑郁 丹栀逍遥散 针刺 血流速度 抑郁症状 

分 类 号：R749.05[医药卫生—神经病学与精神病学]