盐酸帕罗西汀联合天丹通络胶囊治疗脑卒中后抑郁症的疗效观察

目的 探讨盐酸帕罗西汀联合天丹通络胶囊治疗脑卒中后抑郁症（PSD）的临床疗效。方法 将纳入PSD组82例患者随机分为治疗组42例和对照组40例。在常规治疗的基础上，对照组给予盐酸帕罗西汀片口服，20 mg/次，1次/d，早餐后服用。治疗组在对照组的基础上联合使用天丹通络胶囊，2.0 g/次，3次/d。两组疗程均为6周。治疗前后以汉密尔顿抑郁量表（HAMD）评定抑郁程度，以中国卒中量表（CSS）和日常生活能力量表（ADL）分别评定神经功能缺损程度和日常生活能力。结果 治疗2、4、6周后，两组的HAMD量表值均低于治疗前，差异有统计学意义（P<0.05）；治疗组的的总有效率高于对照组，差异有统计学意义（P<0.05）。治疗6周后，治疗组的CSS评分较治疗前显著下降，ADL评分较治疗前显著上升，但治疗组ADL评分明显高于对照组，两组比较差异有统计学意义（P<0.05）。结论 盐酸帕罗西汀联合天丹通络胶囊治疗PSD比单纯使用盐酸帕罗西汀起效快，且能促进神经功能恢复，是值得临床推广的一种治疗方法。

Clinical observation of paroxetine hydrochloride combined with Tiandan Tongluo Capsules in treatment of post stroke depression

Objective To investigate the clinical efficacy of paroxetine hydrochloride combined with Tiandan Tongluo Capsules in the treatment of post stroke depression (PSD).Methods Patients with PSD were 82 cases which were randomly divided into treatment (42 cases) and control (40 cases) groups. On the basis of routine therapy, the patients in the control group were po administered with Paroxetine Hydrochloride Tablets, 20 mg/time after breakfast daily. While the patients in the treatment group were administered combined with Tiandantongluo Capsules every time 2.0 g/time, for three times daily on the basis of control group. The patients in the both groups were treated for 6 weeks. Hamilton depression rating scale (HAMD) was used to evaluate the severity of depression before and after the treatment. Chinese stroke scale (CSS) and daily life ability scale (ADL) respectively were used to evaluate the degree of neurologic deficits and daily life ability. Results In 2, 4, and 6 weeks after the treatment, HAMD values were lower than that in the same group before the treatment, and the difference was statistically significant (P < 0.05). The total effective rate of the treatment group was higher than that in the control group at the same time with significant differences (P< 0.05). Six weeks after the treatment, the CSS scores were lower than those in the same group before the treatment, and ADL scores were higher than those in the same group before the treatment. And there were the significant differences between the two groups (P< 0.05). Conclusion Paroxetine hydrochloride combined with TiandanTongluo Capsules in the treatment of PSD takes the action faster than only using paroxetine hydrochloride, and it can promote neural functional recovery. It is worth of clinic application.