醒脑解郁方加减对缺血性脑卒中痰瘀阻脑证急性期抑郁的临床研究

目的:研究醒脑解郁方加减联合盐酸帕罗西汀对脑卒中急性期抑郁(痰瘀阻脑证)的疗效及血清炎性因子的影响,以期为临床治疗脑卒中急性期抑郁提供有效治法。方法:将112例脑卒中急性期抑郁患者随机分为治疗组与对照组各56例,两组均给予临床常规治疗,对照组给予盐酸帕罗西汀口服,治疗组在对照组基础上给予醒脑解郁方加减,治疗30 d,观察两组治疗前后汉密尔顿抑郁量表(HAMD)评分、匹斯堡睡眠质量指数(PSQI)评分、美国国立卫生院神经功能缺损量表(NIHSS)评分、中医证候量表评分、血清炎性因子肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、5-羟色胺(5-HT)、皮质醇]、不良反应等。结果:①治疗组完全缓解率51.7%,部分缓解率28.5%,总缓解率94.6%;对照组完全缓解率23.2%,部分缓解率33.9%,总缓解率82.1%,两组在缓解率方面比较,差异有统计学意义(P<0.05);②两组治疗后HAMD、PSQI、NIHSS与中医证候量表评分对比,治疗组优于对照组,差异有统计学意义(P<0.05);③两组治疗后血清炎性因子TNF-α、IL-6、5-HT、皮质醇方面比较差异有统计学意义(P<0.05)。结论:醒脑解郁方加减联合盐酸帕罗西汀对脑卒中急性期抑郁(痰瘀阻脑证)有确切疗效,并且可以降低血清炎性因子(TNF-α、IL-6、皮质醇)、升高5-HT的水平。

Effect of Xingnao Jieyu Formula on Depression in Acute Stage of Ischemic Stroke of Phlegm and Stasis Blocking the Brain Sydrome

Objective:To study the effect of Xingnao Jieyu Formula(醒脑解郁方) combined with paroxetine on depression and serum inflammatory factors in acute stage of stroke(phlegm and stasis blocking the brain syndrome),so as to provide an effective treatment for depression in acute stage of stroke. Methods:There were 112 patients with acute depression after stroke randomly divided into treatment group and control group,56 patients in each group. Both groups were given routine clinical treatment. The control group was given paroxetine orally while the treatment group was given oral administration of paroxetine and Xingnao Jieyu Formula. The treatment lasted for 30 days,and the scores of Hamilton depression scale(HAMD),Pittsburgh sleep quality index(PSQI),national institutes of health neurological defects scale(NIHSS),and traditional Chinese medicine(TCM)pattern scale were measured,levels serum inflammatory factorstumor necrosis factor-α(TNF-α),interleukin-6(IL-6),5-hydroxytryptamine(5-HT) and cortisol] were examined,and adverse reactions were determined. Results:In the treatment group the complete remission rate was 51.7%,the partial remission rate was 28.5%,and the total remission rate was 94.6%;in the control group,the complete remission rate was 23.2%,the partial remission rate was 33.9%,and the total remission rate was 82.1%. There was statistical significance on the remission rate between the two groups(P<0.05);treatment group showed improved scores of HAMD,PSQI,NIHSS and TCM pattern scale compared with the control group with statistical significance(P<0.05);also there were statistical significinas between group on the serum inflammatory factors like TNF-α,IL-6,5-HT and cortisol(P<0.05). Conclusions:Xingnao Jieyu Formula combined with paroxetine has definite effect on depression in acute stage of stroke(phlegm and stasis blocking the brain type),and could reduce levels of serum inflammatory factors(TNF-α,IL-6,cortisol),and increase levels of serum 5-HT.