黄精结合米氮平治疗老年脑梗死后抑郁症的临床研究

目的 观察中药黄精结合米氮平治疗脑梗死后抑郁症(PCID)患者的临床疗效及安全性评价.方法 将64例老年PCID患者按照硬币法随机分为研究组(A)组和对照组(B)组,每组各32例患者;A组用中药黄精联合米氮平治疗;B组用米氮平单纯治疗.该研究对患者在治疗前和治疗的第1、2、4、6周末时分别进行汉密尔顿抑郁量表(HAMD)的评估,并记录治疗过程中出现的所有不良反应.结果 治疗前,两组患者的HAMD评分差异无统计学意义(P>0.05),具有可比性.治疗过程中每周末A组HAMD评分下降值较B组更为明显,差异有统计学意义(P<0.05);同期治疗点两组之间相比:A组HAMD评分与B组相比差异有统计学意义(P<0.05).A组总有效率93.33%,B组总有效率86.67%,两组相比差异有统计学意义(P<0.05).A组的不良反应发生率26.67%与B组73.33%相比明显降低,差异有统计学意义(P<0.05).结论 中药黄精结合米氮平治疗老年PCID患者的临床疗效明显优于单纯应用米氮平,并能够减轻并消除治疗过程中的不良反应,值得临床推广.

A clinical observation of rhizoma polygonati combined with mirtazapine in treatment of elderly post-cerebral infarction depression

Objective To observe the clinical efficacy and adverse reactions of rhizoma polygonati combined with mirtazapine in treatment of elderly post-cerebral infarction depression (PCID).Methods Sixty-four elderly PCID patients involved in this study were randomized into rhizoma polygonati combined with mirtazapine group (group A,n=32) and mirtazapine group (group B,n=32).Clinical efficacies were assessed with Hamilton depression rating scale(HAMD) before and 1 week,2 weeks,4 weeks and 6 weeks after the treatment.All the adverse reactions were recorded in the treatment.Results Before the treatment,the scores of HAMD in group A were not different from those in group B (P>0.05).During the treatment,the scores of HAMD in group A at the end of each week decreased more significantly than group B;the difference was statistically significant (P<0.05).At the same time point,there was significant difference in the HAMD scores between the two groups (P<0.05).The total effective rate in group A (93.33%) was significantly higher than that in group B (86.67%) (P<0.05).The adverse reactions in group A(26.67%) were significantly fewer than those in group B(73.33%)(P<0.05).Conclusions Rhizoma polygonati combined with mirtazapine in the treatment of elderly post-cerebral infarction depression was more effective than mirtazapine alone and had fewer adverse reactions,which is worthy of clinical promotion.