舒肝解郁胶囊联合舍曲林治疗老年脑卒中后抑郁疗效及其对神经功能缺损影响的对照研究

目的:观察舒肝解郁胶囊联合舍曲林治疗老年脑卒中后抑郁的临床疗效及其对神经功能缺损的影响。方法:80例老年脑卒中后抑郁患者随机分为研究组(舒肝解郁胶囊联合舍曲林组)41例和对照组(舍曲林组)39例,观察8周。于治疗前、治疗第2、4、8周末分别采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、副反应量表(TESS)评定疗效和副反应,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,并进行实验室监测。结果:至研究终点,研究组和对照组治疗老年脑卒中后抑郁有效率分别为82.9%、61.5%,研究组优于对照组(P<0.05);研究组与对照组HAMD、HAMA分数均显著低于治疗前(P<0.05),两组间比较,研究组评分均低于对照组,差异均有统计学意义(均P<0.05)。治疗后两组均未出现严重不良反应,研究组TESS评分与对照组相当(P>0.05)。治疗后两组CSS评分显著低于治疗前(P<0.05),研究组CSS评分显著低于对照组(P<0.05)。结论:舒肝解郁胶囊联合舍曲林治疗老年脑卒中后抑郁症疗效和对神经功能缺损改善优于单用舍曲林,安全性好。

Comparative Observation on Efficacy of Shuganjieyu Capsules Combined with Sertraline in Treatment of Aged Poststroke Depression

Objective:To observe the clinical efficacy,adverse reactions,and recovery of neural function of Shugan jieyu capsules combined with sertraline in treating aged poststroke depression.Methods:The randomized con trolled tria1 was conducted in 41 aged patients of the study(Shuganjieyu capsules combined with sertraline) group and 39 aged patients of the control(sertraline) group.The therapeutic efficacy,adverse reactions,and neu rological function defect were evaluated with scores by Hamilton Depression Scale,Hamilton Anxiety Scale,Treat ment Emergent Symptoms Scale,and Chinese Scale of Clinical Neurologic Deficit(CSS)before and in 2nd,4th,8th weeks after treatment,respectively.Results:At the end of study,the effective rates of treating aged post stroke depression in the study and the control groups were 81.9% and 61.5%,respectively,with a significant dif ference between them(P<0.05).The scores of HAMD and HAMA were significantly decreased in both groups af ter treatment(P<0.05)and the scores of HAMD and HAMA was significantly lower in the study group than that in the control group(P<0.05).No severe adverse effect was found in both groups.The score of TESS was not statistically different between the 2 groups(P>0.05).The scores of CSS were also reduced in both groups af ter treatment(P<0.05),with a lower score in the study group as compared to that in the control group(P< 0.05).Conclusions:Shuganjieyu capsules combined with sertraline can improve depressive symptoms and promote recovery of neurological function in aged patients with poststroke depression,which is superior than single use of sertraline.