加减血府逐瘀汤治疗脑卒中后抑郁症的随机对照临床研究

Effect of Modified Xuefu Zhuyu Decoction on Post-stroke Depression:A Randomized Controlled Trial

目的观察加减血府逐瘀汤对脑卒中后抑郁症的疗效。方法60例脑卒中后抑郁症患者随机分为3组,A组在卒中常规治疗的同时给予帕罗西汀20m g/d,晨服,并服用加减血府逐瘀汤治疗;B组在卒中常规治疗的同时给予帕罗西汀20m g/d,晨服;C组给予卒中常规治疗;3组均配合心理治疗和康复训练。治疗前及治疗后1月、2月分别用汉密尔顿抑郁量表(hamilton depression rating scale,HAMD)、神经功能量表(neurologic deficit scale,NDS)和日常生活能力量表(activities of daily living scale,ADL)观察疗效。结果治疗前3组H AM D、NDS、ADL评分无统计学差异。治疗1月后,A组和B组三量表评分均优于C组(P<0.05)。治疗2月后A组和B组三项量表评分显著均优于C组(P<0.01),且A组H AM D量表评分优于B组(P<0.05)。A组未见不良反应。结论应用具有理气、化瘀、解郁作用的加减血府逐瘀汤治疗脑卒中后抑郁症有较好临床疗效,且未见明显的副作用。

Objective To observe the effect of Modified Xuefu Zhuyu Decoction （MXZD） on the patients with post - stroke depression. Methods Sixty patients with post -stroke depression were equally randomized 3 groups. The groups A, B and C received routine treatment for stroke. Additionally, group A was given MXZD and paroxetine therapy, and group B was given paroxetine therapy alone. Activities of daily living scale （ADL）, Hamilton＇ s depression scale （HAMD） and neurologic deficit scores were assessed in each patients before treatment, and 1 and 2 month（s） after treatment. Results There were no differences of HAMD, NDS and ADL before treatment between the 3 groups. One and two month （s） after treatment, the scores of HAMD, NDS and ADL in groups A and B were superior to those in group C （ P 〈 0.05 or P 〈 0.01 ）. Two months after treatment, the score of HAMD in group A was superior to that in group B （ P 〈 0.05）. Conclusion Modified Xuefu Zhuyu Decoction, which has the actions of regulating the flow of Qi, removing blood stasis, has certain therapeutic effect on post - stroke depression without side effect.