圣约翰草提取物与文拉法辛治疗脑卒中后抑郁对照研究

目的评价圣约翰草提取物治疗脑卒中后抑郁的临床疗效及安全性。方法将98例脑卒中后抑郁患者随机分为研究组50例，对照组48例，两组患者在神经内科常规治疗的基础上，研究组口服圣约翰草提取物治疗，对照组口服文拉法辛治疗，观察12周。于治疗前及治疗2周、4周、6周、12周末采用汉密顿抑郁量表评定两组抑郁状况，日常生活能力量表评定神经功能康复状况，副反应量表评定不良反应。结果治疗各时段两组汉密顿抑郁量表评分均较治疗前显著下降（P〈0．01），同期两组间比较均无显著性差异（P〉0．05）；治疗4周后日常生活能力量表评分均较治疗前有显著提高（P〈0．01），同期研究组均较对照组提高明显（P〈0．01）。治疗12周末，研究组抑郁改善总有效率84．0％，对照组为83．3％，两组无显著性差异（P〉0．05）；研究组神经功能恢复总有效率84．0％，对照组为52．1％，研究组显著高于对照组（X^2=11．535，P〈0．01）。治疗后两组不良反应发生率均较低，且程度均轻微。结论圣约翰草提取物治疗脑卒中后抑郁疗效与文拉法辛相当，不良反应轻微，同时可促进卒中后神经功能的康复。

A control study of St.John's wort extract vs.venlafaxine in poststroke depression

Objective To evaluate the clinical efficacy and safety of St. Johffs wort extract in the treatment of post-stroke depression （PSI））. Methods 98 PSD patients were randomly divided into research group （n =50） and control group（n=48）, both groups received conventional therapy of neurology department, the research was plus St. John＇s wort extract orally and the control plus venlafaxine for 12 weeks. Depressed conditions were assessed with the Hamilton Depression Rating Scale （HAMD） , nervous function rehabilitation with the Activity of Daily Living Scale（ADLS） and adverse reactions with the Treatment Emergent Symptom Scale（TESS） before treatment and at the end of the 2nd,4th,6th and 12th week. Results After treatment,the H AMD scores of both groups lowered more significantly compared with pretreatment（P〈0.01） ,there were no significant differences in group comparisons in the corresponding time period（P〉0.05）; the ADLS scores of both groups elevated more significantly（P〈0. 01） and so did in the control than in the research in the corresponding time period（P〈0.01）. At the end of the 12th week, total effective rates of depressed emotion improvement were respectively 84.0% in the research and 83.3 % in the control group,which showed no significant difference（P〉0. 05）; those of nervous function rehabilitation were respectively 84.0% in the research and 52.1% in the control,the former was significantly higher than the latter（X^2 =11. 535,P〈0.01）. After treatment ,adverse reactions of both groups had lower incidences and were mild. Conclusion St. Johffs wort extract has an evident effect equivalent to venlafaxine,mild adverse reactions,and higher safety and can promote post-stroke neevous function rehabilitation in the treatment of poststroke depression.