化瘀温胆汤治疗脑卒中后抑郁(风痰火亢证)疗效观察

Effect of the Huayu Wendan decoction on post-stroke depression(syndrome of hyperactivity of wind-phlegm-fire)

目的:观察基于化痰祛瘀法应用化瘀温胆汤治疗脑卒中后抑郁患者的临床疗效。方法:按照《药物临床试验质量管理规范》采用随机对照,选取门诊及住院处就诊的患者,将符合纳入标准的脑卒中后抑郁患者按照随机数字表法分为治疗组(30例)与对照组(30例)。对照组根据指南治疗标准采用西医常规治疗,予抗凝降纤、活血化瘀治疗、脑保护治疗、营养神经治疗等,治疗组在对照组常规治疗基础上结合化瘀温胆汤治疗。观察比较两组患者治疗前后美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、汉密尔顿抑郁评分(Hamilton Depression Scale,HAMD)、汉密尔顿焦虑评分(Hamilton Anxiety Scale,HAMA)、Barthel指数(Barthel Index,BI)、中医证候积分。结果:两组患者治疗30 d后NIHSS评分、HAMD评分、HAMA评分、BI、中医证候积分较治疗前显著降低(P<0.05);治疗后组间比较,治疗组评分显著低于对照组(P<0.05)。结论:基于化痰祛瘀法运用化瘀温胆汤治疗脑卒中后抑郁患者可显著改善患者临床症状、焦虑抑郁情况,提高生活能力。

Objective:To observe the clinical effect of the Huayu Wendan decoction(化瘀温胆汤)on post-stroke depression patients based on the method of resolving phlegm,removing blood stasis and clearing blood.Methods:According to GCP standard,patients in outpatient and inpatient departments were selected,and patients with post-stroke depression who met the inclusion criteria were divided into the treatment group(30 cases)and the control group(30 cases)according to the random number table method.The control group received conventional treatment of western medicine according to the treatment guidelines,including to anticoagulation and fiber reduction,blood circulation and blood stasis removal treatment,brain protection treatment,nutritional nerve treatment,etc..The treatment group was treated with the Huayu Wendan decoction more.National institutes of health stroke scale(NIHSS)score,Hamilton depression score(HAMD),Hamilton anxiety score(HAMA),Barthel index(BI)and TCM syndrome score in two groups were observed before and after treatment.Results:NIHSS score,HAMD,HAMA and BI,TCM syndrome score were significantly lower in both groups after 30 days of treatment(P<0.05).The post-treatment scores in the treatment group were significantly lower than the control group(P<0.05).Conclusion:Based on the method of resolving phlegm,removing blood stasis and clearing blood,the Huayu Wendan decoction can significantly relieve the clinical symptoms,anxiety and depression,and improve the life ability in the treatment of post-stroke depression patients.