柴胡疏肝散加味治疗卒中后抑郁的临床观察与机制分析

目的:观察柴胡疏肝散加味治疗卒中后抑郁(PSD)的临床疗效,并探讨其机制。方法:将94例PSD患者随机分组,治疗组予柴胡疏肝散加味,对照组予氟西汀,治疗4周后评价疗效、HAMD评分和测定血清单胺类神经递质水平,以TESS量表评定不良反应。结果:两组间疗效无显著性差异(P>0.05)。两组治疗后HAMD评分均较治疗前明显改善(P<0.01),组间无显著性差异。两组治疗后血清单胺类神经递质水平均较治疗前明显升高(P<0.05或P<0.01),组间无显著性差异。不良反应方面,治疗组较对照组明显减少(P<0.05或P<0.01)。结论:柴胡疏肝散加味治疗卒中后抑郁疗效确切,不良反应少,其作用机制可能与其升高患者血清单胺类神经递质水平有关。

Clinical Observation and Mechanism Analysis of Chaihu Shugan Powder Used in Patients with Post-stroke Depression

Objective:To observe the clinical efficacy of Chaihu Shugan Powder in patients with post-stroke depression(PSD),and to explore its mechanism.Methods:94 PSD patients were grouped randomly into Chaihu Shugan Powder group and fluoxetine group,and the clinical efficacy was evaluated with the HAMD scale,the serum monoamine neurotransmitter levels were determined,and the adverse reactions were assessed with the TESS scale after 4 weeks of treatment.Results:There was no significant difference(P>0.05)between two groups in clinical efficacy.HAMD score was improved significantly(P<0.01)in both groups after treatment,but there was no significant difference between two groups.Serum monoamine neurotransmitter levels were increased significantly(P<0.05 or P<0.01)in both groups after treatment,but there was no significant difference between two groups.The Chaihu Shugan Powder group had fewer adverse reactions than the fluoxetine group(P<0.05 or P<0.01).Conclusion:Chaihu Shugan Powder is effective and safe in treating PSD,and its mechanism may be related to the increased serum monoamine neurotransmitter levels in PSD patients.