舒肝解郁胶囊与西酞普兰治疗老年缺血性脑卒中后抑郁的疗效比较

摘要目的观察舒肝解郁胶囊治疗老年轻中度缺血性脑卒中后抑郁的临床疗效和对神经功能缺损的影响。方法老年轻中度缺血性脑卒中后抑郁患者84例，随机分为治疗组和对照组各42例。治疗组口服舒肝解郁胶囊0.72 g，bid；对照组口服西酞普兰片 20 mg，qd。疗程均为6周。于基线及治疗第2，4，6周末分别采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、临床总体印象量表（CGI）、治疗时出现的不良反应症状量表（TESS）评定疗效和不良反应，采用中国脑卒中患者临床神经功能缺损评分标准（CSS）评定对神经功能缺损的影响。结果至研究终点，治疗组和对照组有效率分别为69.0%，64.3%（P＞0.05）；两组HAMD、HAMA评分均显著低于基线（P＜0.05），两组间比较差异无统计学意义（P＞0.05）。治疗6周末，治疗组的TESS评分显著低于对照组（P＜0.01），疗效指数显著高于对照组（P＜0.01）。治疗6周末两组CSS评分均显著低于基线，治疗组的CSS评分显著低于对照组（P＜0.05）。结论舒肝解郁胶囊治疗轻中度缺血性抑郁症疗效与西酞普兰相当，不良反应明显少于西酞普兰，并能促进神经功能康复。

Efficacy Comparation of Shuganjieyu Capsule and Citalopram on Treatment of Ischemic Poststroke Depression in Aged Patients

Objective To investigate the clinical efficacy for treating mild and moderate ischemic poststroke depression in aged patients and effect on neural dysfunction of shuganjieyu capsule.Methods A total of 84 aged patients with mild and moderate ischemic poststroke depression were randomly assigned to the test group and the control group(n=42,each).The test group was treated with shuganjieyu capsule(0.72 g,bid),and the control group was treated with citalopram tablet(20 mg,qd) for 6 weeks.The therapeutic efficacy,adverse reactions and neurological dysfunction were evaluated at the beginning and by the end of 2-,4-,6-week after treatment by Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Clinical Global Impression(CGI),Treatment Emergent Symptoms Scale(TESS),and Chinese Scale of Clinical Neurologic Deficit(CSS),respectively.Results By the end of study,the efficacy of the test group and the control group was 69.0% and 64.3%,respectively(P>0.05).And the scores of HAMD and HAMA were significantly lower than those at the start(P<0.05),and no statistically significant difference was found between two groups(P>0.05).The TESS was conspicuously fewer in the test group than that in the control group(P<0.01),while the efficacy index of which was remarkably superior than that of the control group(P<0.01).By the 6th weekend,the CSS was significantly lower than that at the beginning and that in control group(P<0.05).Conclusion Shuganjieyu capsule presents the similar effect as citalopram on treating mild and moderate poststroke depression in aged patients with less side effects and promotes neurological function recovery.