加味柴胡疏肝颗粒辅助治疗缺血性脑卒中后抑郁的疗效观察

目的探讨加味柴胡疏肝颗粒辅助治疗缺血性脑卒中后抑郁(PSD)的临床疗效。方法将100例缺血性PSD患者随机分成治疗组和对照组各50例,两组均予脑血管病常规治疗,同时对照组给予口服氢溴酸西酞普兰每日1次,每次20 mg,治疗组在对照组基础上给予加味柴胡疏肝颗粒口服治疗,两组均治疗8周。分别于治疗前及治疗4、8周后进行两组患者汉密尔顿抑郁量表(HAMD)评分、Barthel Index(BI)指数评分,测定血清脑源性神经生长因子(BDNF),并于治疗后评价临床疗效。结果治疗组临床疗效总有效率为94.0%,优于对照组(72.0%,P0.05)。两组治疗4、8周后HAMD评分均较本组治疗前下降,BI指数升高(P0.01);且治疗8周后改善更加显著(P0.01)。同期治疗组HAMD评分低于对照组(P0.01),BI指数高于对照组(P0.01)。两组治疗4、8周后血清BDNF均较本组治疗前有显著升高,治疗8周后升高更明显(P0.01)。治疗组4周血清BDNF高于对照组(P0.05),8周时差异更显著(P0.01)。结论加味柴胡疏肝颗粒辅助治疗缺血性PSD可提高临床疗效,改善日常生活活动能力及抑郁状态,其作用可能与升高患者血清BDNF水平有关。

Clinical observation on efficacy of Modified Chaihu Shugan Granule for treating post ischemic stroke depression

Objective To observe the efficacy of Modified Chaihu Shugan Granule on post ischemic stroke depression (PSD) patients, and to explore its effect on serum brain-derived neurotrophic factor (BDNF).Methods Totally 100 patients with PSD were randomly devided into treatment group (50 cases) and control group (50 cases). Both groups were given the conventional treatment of ischemic cerebrovascular disease, while the control group also took citalopram hydrobromide, once a day, 20 mg each time. Additionally, the treatment group was given Modified Chaihu Shugan Granule. The therapeutic course for all was 8 weeks. Before treatment and 4, 8 weeks after treatment, scores of Hamilton depression rating scale (HAMD) and Barthel Index of both groups were observed to evaluate clinical effects. Serum levels of BDNF were detected at the same time.Results Total effective rate of clinical effects in the treatment group (94.00%) was better than that of the control group (72.00%) (P<0.05). Compared with before treatment in the same group, HAMD scores all obviously decreased but the scores of Barthel Index and serum levels of BDNF increased (P<0.01), while those after the treatment for 8 weeks showed greater improvements (P<0.01). Separately, HAMD scores of the treatment group were lower than those of the control group at 4 and 8 weeks after the treatment (P<0.01), while the scores of Barthel Index increased all along (P<0.01). Serum levels of BDNF in the treatment group were obviously higher than those in the control group at 4 weeks after the treatment (P<0.05), while it was a significant difference at 8 weeks (P<0.01).Conclusion Modified Chaihu Shugan Granule used for treating the patients with PSD could improve the clinical efficacy, activities of daily living, and depressive state. Its mechanism might be associated with inhibiting serum levels of BDNF.