调气活血法治疗中风后情绪障碍的临床观察

目的 观察运用调气活血法治疗中风后情绪障碍的临床效果及安全性.方法 采用临床随机对照试验方案,选择2011年1月～2013年1月的121例患者随机分为治疗组61例和对照组60例,在内科常规治疗基础上,治疗组按中医辨证给予丹栀逍遥散、柴胡加龙骨牡蛎汤、血府逐瘀汤、归脾汤加减方治疗,对照组口服盐酸氟西汀治疗.观察两组患者治疗前及治疗2、4、6周后汉密尔顿抑郁量表评分(HAMD)、汉密尔顿焦虑量表评分(HAMA)进行临床疗效评价,使用美国国立卫生院神经功能缺损评分(NIHSS)评价神经功能,使用脑卒中专用生活质量量表评分(SS-QOL)评价生活质量,采用治疗药物副反应量表(TESS)评价不良反应情况.结果 治疗组总有效率(80.33％)与对照组总有效率(83.33％)比较,差异无统计学意义(P＞0.05).治疗后两组患者HAMD、HAMA、NIHSS、SS-QOL评分均明显改善,治疗前后比较差异有统计学意义(P＜0.05).治疗组不良反应发生率低于对照组,差异有统计学意义(P＜0.05).结论 运用调气活血法治疗中风后情绪障碍临床效果明显,与对照药氟西汀具有类似疗效,而副作用少,值得临床推广应用.

Clinical observation on emotional disorder after stroke treated by regu- lating qi and activating blood

Objective To observe the clinical effect and safety of regulating qi and activating blood treatment for emo- tional disorder patients after stroke. Methods The study was used clinical randomized controlled trial. 121 patients from January 2011 to January 2013 were divided randomly into the treatment group （n = 61） and the control group （n = 61）. Based on internal routine treatment, the treatment group was given Danzhi Xiaoyao Powder, Bupleurum plus Dragon Bone and Oyster Shell Decoction, Xuefu Zhuyu Decoction or Decoction for Invigorating the Spleen according to syndrome differentiation; while the control group was given oral Fluoxetine Hydrochloride. Hamilton depression scale （HAMD） and Hamilton anxiety scale （HAMA） were used for evaluation of clinical effect in the two groups before treat- ment and after treatment for 2, 4 weeks and 6 weeks. National institutes of health stroke scale score （NIHSS） was used for evaluation of nerve function, stroke specific quality of life scale （SS-QOL） was used for evaluation of life quality, and treatment emergent symptom scale （TESS） was used for evaluation of adverse events. Results The total effective rate in the treatment group and the control group was 80.33% and 83.33% respectively, which had no statically signif- icant difference （P 〉 0.05）. The score of HAMD, HAMA, NIHSS and SS-QOL in the treatment group was significantly improved after treatment （P 〈 0.05）, and the adverse reaction rate of the treatment group was significantly lower than that of the control group （P 〈 0.05）. Conclusion The clinical effect of regulating qi and activating blood treatment for emotional disorder patients after stroke is excellent similar to the effect of fluoxetine hydrochloride, and has little ad- verse reaction which should be expanded in clinic.