中西医结合治疗中风后抑郁症30例临床观察

目的观察中西医结合治疗中风后抑郁症的临床疗效。方法60例中风后抑郁症患者随机分为治疗组和对照组（各30例）,观察治疗6周。对照组采用氟西汀治疗,治疗组在对照组基础上加郁星菖志汤治疗。于治疗前及治疗1周、2周、4周、6周末采用汉密顿抑郁量表（HAMD）评定抗抑郁疗效,记录不良反应;于治疗前及治疗6周末采用爱丁堡-斯堪的那维亚卒中量表（MESSS）评定神经功能缺损程度。结果治疗6w末治疗组与对照组治疗卒中后抑郁有效率分别为83.3%、73.3%;HAMD评分治疗组1w末起较治疗前有极显著性下降（P〈0.01）,对照组治疗2周末起有极显著性下降（P〈0.01）;MESSS评分两组6w末均较治疗前有极显著性下降（P〈0.01）,两组间比较有显著性差异（P〈0.05）。两组不良反应均轻微,对比无显著性差异（P〉0.05）。结论中西医结合治疗卒中后抑郁疗效较氟西汀好,且起效更快,不增加不良反应,有利于患者神经功能的康复。

Clinical observation of combination of TCM and western medicine in Treating patients with Post-stroke Depression

Objective To observe the effect of combination of TCM and western medicine in treating patients with post-stroke depression(PSD).Methods 60 patients with PSD were randomly assigned into treatment and control groups(each n=30) for 6 weeks.Treatment with "Yuxingchangzhi decoction" and fluoxetine was initiated in treatment group,Controls were treated with fluoxetine.Treatment efficacy was evaluated with Hamilton Depression Scale(HAMD) before treatment and during the follow-up period(1st,2nd,4th and 6th week),respectively;side effects were recorded and stroke severity measured by MESSS before treatment and at 6th week.Results At 6th week,the total efficacy rate were 83.3%in treatment group and 73.3%in controls.In treatment group a significant decrease of the HAMD scores(P<0.01) were seen in 1st week,and 2nd week for Controls.Scores of the MESSS of both groups were decreased significantly at 6th week(both P<0.01),compared with controls there was significant difference in treatment group(P<0.05).There were no significant side effects in two groups(P<0.05).Conclusion Combination of TCM and western medicine is effective in the treatment of PSD,takes effects faster,has higher safety,and promote the rehabilitation of nervous function.