神宁方联合西药治疗脑梗死恢复期伴轻中度抑郁患者60例临床观察

A Clinical Observation on Shenning Formula Combined with Western Medicine for 60 Patients With Cerebral Infarction in Convalescence Complicated With Mild to Moderate Depression

目的观察神宁方联合西药治疗脑梗死恢复期伴轻中度抑郁的临床疗效。方法 120例脑梗死恢复期伴轻中度抑郁患者随机分为治疗组和对照组各60例,对照组口服阿司匹林肠溶片和盐酸舍曲林,治疗组在对照组基础上加服神宁方治疗,每日1剂,两组疗程均为30天。于治疗前后采用17项汉密顿抑郁量表(HAMD-17)、美国国立卫生研究院卒中量表(NIHSS)、mRS残障评级和Barthel指数(BI)评分进行两组患者疗效评价。结果治疗前HAMD-17评分在8～16分者,治疗组治疗后评分低于本组治疗前及对照组治疗后(P<0.05或P<0.01),治疗前HAMD-17评分在17～23分者,两组评分均低于本组治疗前(P<0.01)。治疗组HAMD-17量表中抑郁情绪、睡眠不深、早醒和胃肠道症状因子评分低于本组治疗前和对照组治疗后(P<0.05或P<0.01);治疗组患者服用盐酸舍曲林平均剂量低于本组治疗前及对照组治疗后(P<0.01);治疗后治疗组NIHSS评分显效、mRS残障评级0～2级和BI评分≥85分的病例数均多于对照组(P<0.05)。结论神宁方联合西药治疗脑梗死恢复期伴轻中度抑郁,可以改善患者的抑郁症状,减少患者每日服用盐酸舍曲林平均剂量,促进患者神经功能恢复,降低患者残障评级,提高患者日常生活能力。

Objective To observe the therapeutic effect of Shenning Formula（Tranquilizing Formula） combined with western medicine for patients recovering from acute cerebral infarction complicated with mild to moderate depression（ACID）.Methods Totally 120 ACID patients were randomized into the treatment group and control group,with 60 in each.Both groups were orally given enteric-coated aspirin tablets and sertraline hydrochloride.The treatment group was added with one dose of Shenning Formula daily.The treatment lasted for 30 days.The therapeutic effect was evaluated with Hamilton Depression Rating Scale（HAMD）,National Institutes of Health Stroke Scale（NIHSS）,Modified Rankin Scale（mRS）,and Barthel Index（BI）.Results After treatment,the HAMD scores ranging from 8 to 16 points before treatment were significantly decreased in the treatment group and lower than those in the control group（P〈0.01）.After treatment,the HAMD scores ranging from 17 to 23 points before treatment were significantly decreased in both groups（P〈0.01）,and 4 factor scores of depression,easy to wake up,early awakening,and gastrointestinal symptoms in the treatment group were significantly lower than those in the control group（P〈0.05or P〈0.01）.The average dose of sertraline in the treatment group was significantly decreased after treatment and lower than that in the control group（P〈0.01）.After treatment,the number of patients whose NIHSS score improvement greater than or equal to 40%,mRS rating from 0 to 2,and BI score greater than or equal to 85 points in the treatment group was more than that in the control group（all P〈0.05）.Conclusion Integrative medicine can relieve the depressive symptoms,reduce daily average dose of sertraline,promote recovery of neurological function,reduce disability rating,and improve daily living skills of ACID patients.