中西医结合治疗脑卒中后抑郁130例疗效分析

Therapy Effects of Combined Traditional Chinese and Western Medicine Treatment on 130 cases with Post Stroke Depression

目的:探讨中西医结合治疗对脑卒中后抑郁(PSD)的疗效。方法:PSD患者130例随机分为对照组和观察组,各65例。2组均按常规治疗,在此基础上,对照组给予草酸艾司西酞普兰片口服及综合康复治疗,观察组给予豁痰清窍解郁汤、草酸艾司西酞普兰片口服及综合康复治疗,均治疗8周。于治疗前后采用汉密尔顿抑郁量表(HAMD)、神经功能缺损程度评分、简易精神状态评定量表(MMSE)及改良Barthel(MBI)指数对患者的抑郁程度、运动功能、认知功能及ADL能力进行评定。结果:治疗前,2组患者HAMD、神经功能缺损程度、MMSE及MBI评分差异无统计学意义(P>0.05)。治疗后,2组HAMD、神经功能缺损程度、MMSE及MBI评分均较组内治疗前有所改善(P<0.05);观察组改善程度高于对照组(P<0.05)。对照组和观察组抑郁治疗总有效率分别为78.5%和90.8%,神经功能缺损程度改善的总有效率为70.8%和86.1%,观察组的总有效率高于对照组(P<0.05)。结论:中西医结合治疗有助于改善PSD患者的抑郁状态、运动功能、认知功能及生活质量。

Objective： To investigate the therapy effects of combined traditional Chinese and western medicine treatment on 130 cases with post stroke depression（PSD）. Methods： One hundred and thirty patients with PSD were randomly divided into control group and observation group, 65 cases in each group. Based on routinely handling,cases in control group were treated with escitalopram oxalate citalopram tablets and comprehensive routine rehabilitation training and cases in observation group were treated with clear phlegm qing qiao resolve depression soup,escitalopram oxalate citalopram tablets and comprehensive routine rehabilitation training for 8 weeks. Then the degree of depression, motor function, cognitive function and ADL ability were assessed with Hamilton depression scale（HAMD）, neurological deficit scale（NDS）, mimi-mental state examination（MMSE） and Modified Barthel Index（MBI） before and after treatment. Results： Before treatment, there was no statistic difference of HAMD, NDS,MMSE and MBI scores between two groups（P〉0.05）. After treatment, the scores of HAMD and NDS were decreased and the scores of MMSE and MBI were increased compared with those before treatment（P〈0.05）. After treatment, the HAMD and NDS scores of observation group were lower than those of control group and the MMSE and MBI scores of observation group were higher than those of control group（P〈0.05）. The total efficiency of the treatment of depression was 8.5% in control group and 90.8% in observation group（P〈0.05）. The total efficiency of the treatment of neurological deficits improvement was 70.8% in control group and 86.1% in observation group（P〈0.05）. Conclusion： Combined traditional Chinese and western medicine treatment is benefit for the improvement of depressive state, motor function, cognitive function, and quality of life of patients with PSD.