温阳解郁汤对脑卒中后抑郁患者血清炎症因子和单胺类递质水平及肠道菌群的影响  

Effect of Wenyang Jieyu Decoction(温阳解郁汤)on Serum Inflammatory Factors,Monoamine Transmitters and Intestinal Microflora in Post-stroke Depression Patients

作　　者：黄俊东[1] 吴升伟[1] 卢秋伶 章慧[1] 李一兰 HUANG Jundong;WU Shengwei;LU Qiuling;ZHANG Hui;LI Yilan(Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510370,Guangdong,China)

机构地区：[1]广州医科大学附属脑科医院,广东广州510370

出　　处：《中华中医药学刊》2025年第2期37-40,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(82004226);广州市科技局市校(院)联合项目(2023A03J0855);广州市中医治未病服务提升工程建设项目(510101-0101193)。

摘　　要：目的探讨温阳解郁汤对脑卒中后抑郁(Post stroke depression,PSD)患者血清炎症因子和单胺类递质水平及肠道菌群的影响。方法选择2020年1月—2023年3月收治的PSD患者90例,采用随机数字表法将其分为对照组与观察组各45例。对照组口服盐酸帕罗西汀片,观察组在对照组基础上服用温阳解郁汤。两组治疗周期8周。比较两组治疗疗效;治疗前后日常生活能力、抑郁情绪和神经功能,炎症因子,单胺类神经递质和肠道菌群变化。结果观察组PSD患者总有效率高于对照组(P<0.05)。两组治疗后PSD患者日常生活活动能力(Daily Activity Level,ADL)评分高于治疗前,而汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分和美国国立卫生研究院卒中量表(National institute of health stroke scale,NIHSS)评分低于治疗前(P<0.05);观察组治疗后PSD患者ADL评分高于对照组,而HAMD评分和NIHSS评分低于对照组(P<0.05)。两组治疗后PSD患者血清肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(Hypersensitive C-reactiveprotein,hs-CRP)和白介素-6(Interleukin-6,IL-6)水平低于治疗前(P<0.05);观察组治疗后PSD患者血清TNF-α、hs-CRP和IL-6水平低于对照组(P<0.05)。两组治疗后PSD患者血清NE、5-HT和DA水平高于治疗前(P<0.05);观察组治疗后PSD患者血清去甲肾上腺素(Norepinephrine,NE)、5-羟色胺(5-hydroxytryptamine,5-HT)和多巴胺(Dopamine,DA)水平高于对照组(P<0.05)。两组治疗后PSD患者乳酸杆菌和双歧杆菌高于治疗前,而肠球菌和大肠埃希菌低于治疗前(P<0.05);观察组治疗后PSD患者乳酸杆菌和双歧杆菌高于对照组,而肠球菌和大肠埃希菌低于对照组(P<0.05)。结论温阳解郁汤对PSD患者疗效良好,可显著减轻患者炎症反应,调节单胺类递质水平,及改善肠道菌群变化。Objective To explore the effects of Wenyang Jieyu Decoction(温阳解郁汤)on serum inflammatory factors,monoamine neurotransmitter levels and intestinal microbiota in patients with post-stroke depression(PSD).Method Ninety PSD patients admitted to the hospital from January 2020 to March 2023 were selected and divided into control group(45 cases)and observation group(45 cases)by using a random number table method.The control group took Paroxetine Hydrochloride Tablets orally,while the observation group took Wenyang Jieyu Decoction on the basis of control group.The treatment period for two groups was 8 weeks.The therapeutic effects of two groups were compared.The changes in daily living ability,depressive mood,neurological function,inflammatory factors,monoamine neurotransmitters and gut microbiota were compared before and after treatment.Results The effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the daily activity level(ADL)scores of two groups were higher than those before treatment,while the Hamilton depression scale(HAMD)score and National Institute of Health stroke scale(NIHSS)score were lower than those before treatment(P<0.05).The ADL score of the observation group was higher than that of the control group after treatment,while the HAMD score and NIHSS score were lower than those of the control group(P<0.05).After treatment,the levels of serum tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)and interleukin-6(IL-6)of two groups were lower than those before treatment(P<0.05).And the levels of the observation group were lower than those of the control group(P<0.05).After treatment,the levels of serum norepinephrine(NE),5-hydroxytryptamine,(5-HT)and dopamine(DA)of two groups were higher than those before treatment(P<0.05)and the levels of the observation group were higher than those of the control group(P<0.05).After treatment,the levels of lactobacilli and bifidobacteria of two groups were higher than those before treatment,w

关 键 词：温阳解郁汤 脑卒中 抑郁 炎症因子 单胺类神经递质 肠道菌群 

分 类 号：R255.2[医药卫生—中医内科学]