越鞠丸对急性脑梗死伴抑郁患者的临床疗效及颈动脉斑块的影响

目的:评价越鞠丸对急性脑梗死伴抑郁患者的临床疗效以及对颈动脉斑块稳定性的影响。方法:将急性脑梗死伴发抑郁患者120例,随机分为观察组与对照组。观察组口服越鞠丸,对照组口服氟哌噻吨美利曲辛片(商品名:黛力新),共3个月。观察两组患者神经功能缺损评分(NIHSS)与日常生活能力指数(Barthel)评分变化,检测血脂、颈动脉斑块以及血清单核细胞趋化因子-1(MCP-1)、超敏C-反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)相关炎性因子的变化。结果:治疗后,两组患者NIHSS与Barthel均较治疗前改善(P0.05),其中观察组优于对照组(P0.05);两组抑郁程度评分较治疗前改善(P0.05),但组间差异无统计学意义(P0.05)。治疗后,两组低密度脂蛋白、总胆固醇、三酰甘油水平均下降,高密度脂蛋白水平上升,颈动脉软斑块、斑块积分减少,混合斑块比例增加(P0.05),其中观察组改善幅度优于对照组(P0.05)。治疗后,两组血清MCP-1、hs-CRP、MMP-9水平均较治疗前显著下降(P0.05),其中观察组优于对照组(P0.05)。结论:越鞠丸可以减轻急性脑梗死患者抑郁症状,改善神经功能缺损程度,提高患者日常生活能力;同时对于稳定颈动脉斑块性质具有良好作用。

Clinical efficacy of Yueju Pill on patients of acute cerebral infarction with depression and its effects on carotid plaque

  Objective: To evaluate the clinical efficacy of Yueju Pill on patients of acute cerebral infarction with depression and its effects on the stability of carotid plaque.   Methods: 120 patients of acute cerebral infarction with depression were randomly divided into the observation group and control group. The observation group was orally treated with Yueju Pill, while the control group was orally treated with flupentixol and melitracen tablets (Deanxit), with a course of 3 months. The changes of neurological deficit score (NIHSS) and daily living activity index (Barthel) were observed. The levels of blood lipids, carotid plaque, monocyte chemotactic protein-1 (MCP-1),hypersensitive C-reactive protein (hs-CRP) and matrix metalloproteinase-9 (MMP-9) were detected.   Results: After treatment, the NIHSS and Barthel were improved in both groups (P<0.05),and the observation group was superior to the control group (P<0.05). The score for depression was improved in both groups (P<0.05),but there was no significant difference between the two groups (P>0.05). After treatment, the levels of low density lipoprotein, total cholesterol and triglyceride were decreased in both groups, and the high density lipoprotein level was increased, the scores of carotid soft plaque and carotid plaque were decreased,and the proportion of mixed plaque was increased (P<0.05). The improvement in the observation group was better than that in the control group (P<0.05). After treatment, the serum levels of MCP-1, hs-CRP and MMP-9 were significantly decreased in both groups (P<0.05),and the observation group was superior to the control group (P<0.05).   Conclusion: Yueju Pill can alleviate the depressive symptoms of patients with acute cerebral infarction, improve the degree of neurological deficits and improve the ability of daily living, and shows a good effect on stabilizing the nature of carotid plaque.