卒中单元中西医结合治疗卒中后抑郁-焦虑共病的临床研究

Clinical Study of Integrative Medicine on the Treatment of Patients with Post-stroke Comorbid Depression and Anxiety in Stroke Unit

目的:观察卒中单元中西医结合治疗脑卒中后抑郁-焦虑共病(PSCAD)的临床疗效。方法:PSCAD患者146例随机分为对照组85例,治疗组61例;2组均采用卒中单元的常规治疗,对照组给予盐酸舍曲林片口服,治疗组在对照组治疗的基础上,加用中草药方;于治疗前和治疗后第2、4、8、24周采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、美国国立卫生研究院卒中量表(NIHSS)及Barthel指数(BI)对患者进行评分。结果:治疗2周后,治疗组的HAMD及HAMA评分即低于对照组(P<0.05);治疗4周后,治疗组的NIHSS评分低于对照组且BI高于对照组(P<0.05)。结论:卒中单元中西医结合治疗不仅有助于改善患者卒中后抑郁-焦虑状态,还能促进患者神经功能缺损的恢复,提高患者的生活质量。

Objective： To study the efficacy of integrative medicines on post-stroke comorbid depression and anxiety （PSCAD） patients in stroke unit. Methods. One-hundred and forty- six cases of PSCAD in stroke unit were randomly divided into control group （n=85） and treat- ment group （n=61）. All the cases received the routine treatment. Patients in the control group were treated with flupentixol, and in the treatment group with flupentixol plus Chinese medicine. All the cases were assessed with Hamilton depression scale （HAMD）, Hamilton anxiety scale （HAMA）, National Institutes of Health Stroke Scale （NIHSS） and barthel index （BI） before treatment and at 2, 4, 8 and 24 weeks post-therapy respectively. Results： Two weeks after treat- ment, the scores of HAMD and HAMA of the treatment group were lower than those in the con- trol group （P^0.05）. Four weeks after treatment, the score of NIHSS was lower and the score of BI was higher in the treatment group than those in the control group （P〈0.05）. Conclusion： In stroke unit, integrative medicine treatment can effectively attenuate the depression and anxie- ty, accelerate neurologic recover and improve the activities of daily living of patients with PSCAD.