中西医结合治疗急性脑梗死伴抑郁70例

70 Cases of Acute Cerebral Infarction Accompanied with Depression Treated with Integrated Western and Chinese Medicine

目的：观察中西医结合治疗急性脑梗死伴抑郁（气虚血瘀证）的临床疗效方法：选取急性脑梗死伴抑郁（气虚血瘀证）患者140例，按照随机数字表法分为观察组和对照组各70例。对照组给予阿司匹林和盐酸舍曲林口服治疗，观察组在对照组治疗的基础上加用自拟安神汤治疗，两组疗程均为30d。结果：治疗后两组患者HAMD－17评分均较治疗前明显改善，且观察组明显优于对照组（P〈0．05）；治疗后观察组患者睡眠不深、早醒、抑郁情绪和胃肠道症状评分均明显优于对照组（P均〈0．05）；观察组患者使用盐酸舍曲林的剂量明显低于对照组（P〈0.05）：观察组NIHSS评分、mltS残障评级（0～2级）和Harthed指数评分≥85分改善情况均明显优于对照组（P均〈0．05）结论：中西医结合治疗急性脑梗死伴抑郁（气虚血瘀证）可显著改善抑郁症状，减少盐酸舍曲林的使用剂量，促进神经功能恢复，降低残障评级，提高日常生活活动能力。

Objective ：To observe the clinical effect of the treatment of acute cerebral infarction （ACI） accompanied with depres- sion（ syndrome of qi deficiency and blood stasis） treated with integrated western and Chinese medicine. Methods： 140 cases with ACI accompanied with depression were randomized into control group （70 cases） orally given aspirin and sertraline hydrochloride and observation group （70 cases） additionally given self-formulated Mind-Calming Decoction,with 30 days as a treatment course for both group. Results：The HAMD-17 scores of both group got improved obviously after treatment;the eftect in observation group was more significant than that in control group （ P 〈 0.05 ）. Alter the treatment, the symptom scores of shallow sleep, early awak- ening,depressed mood aud gastrointestinal symptoms were all better than those in control group （P 〈 0.05 ）. The dosage of sertra- line hydrochloride used in observation group was greatly lower than that in control group （P 〈 0.05 ）. The scores of NIHSS, mRS disability rating （ level 0 ～ 2 ） and the improvement of Barthel index ≥85 were all better than those in control group （ P 〈 0.05 ）. Conclusion ： Integrated western and Chinese medicine can renmarkably improve the depression symptoms, reduce the dosage of ser- traline hydrochloride, promote the recovery of nervous function,lowering disability rating and enhance abilities of activities in daily living.