银杏叶片联合低频重复经颅磁刺激治疗腔隙性脑梗死后焦虑抑郁共病疗效及对血液流变学的影响

Curative effect of ginkgo leaf tablet combined with low frequency repetitive transcranial magnetic stimulation on anxiety and depression after lacunar infarction and effect on blood rheology

目的观察银杏叶片联合低频重复经颅磁刺激治疗腔隙性脑梗死后抑郁焦虑共病的临床疗效及对血液流变学的影响。方法将121例腔隙性脑梗死后焦虑抑郁共病患者随机分为观察组61例和对照组60例,对照组给予低频重复经颅磁刺激治疗,观察组在对照组治疗基础上给予银杏叶片口服,1片/次,3次/d,疗程12周;观察2组治疗前后汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、美国国立卫生研究院卒中量表(NIHSS)及Barthel(BI)指数评分、36条目简明健康量表(SF-36)评分及血液流变学指标变化情况。结果2组治疗后HAMA、HAMD、NIHSS、BI评分均显著改善(P均<0.05),观察组上述指标改善情况显著优于对照组(P均<0.05);2组治疗后SF-36评分中的生理功能(PF)、生命活力(VT)、总体健康感(GH)、躯体疼痛(BP)、生理职能(RP)、社会功能(SF)、心理健康(MH)、情感职能(RE)评分均有提高(P均<0.05),且观察组上述指标改善情况显著优于对照组(P均<0.05);2组治疗后全血黏度低切、中切及高切,血浆黏度、红细胞聚集指数均有明显降低(P均<0.05),且观察组上述指标均低于对照组(P均<0.05)。结论银杏叶片联合低频重复经颅磁刺激治疗能够显著改善腔隙性脑梗死后焦虑抑郁共病患者的血液流变学及焦虑抑郁情绪,促进患者神经功能、独立生活能力及生活质量的提高。

Objective It is to observe the clinical curative effect of ginkgo leaf tablet combined with low frequency repetitive transcranial magnetic stimulation on anxiety and depression after lacunar infarction and effect on blood rheology. Methods 121 cases of patients with anxiety and depression after lacunar infarction were randomly divided into observation group （n = 61 ） and control group （n = 60） , the control group was treated with low-frequency repetitive transcranial magnetic stimulation, the observation group was given ginkgo leaf tablet orally on the basis of treatment in control group, one tablet per day, 3 times/ d, the treatment course was 12 weeks. The changes of scores of Hamilton anxiety scale （HAMA） and Hamilton depression scale （HAMD）, the United States national institutes of health stroke scale （NIHSS） and the Barthel index （BI） score, 36 items concise health scale （ SF - 36） score and indexes of hemorheology before and after treatment were observed in both groups. Results After treatment, the scores of HAMA, HAMD, NIHSS and BI were significantly improved （P 〈 0.05） in both groups （P 〈 0.05 ）, and the improvements of these indexes in observation group were better than that in control group （ P 〈 0. 05） ; the scores of SF -36 scale such as physiological function （PF） , vitality （VT） , general health （GH） , body pain （ BP）, physiological functions （ RP）, social function （ SF）, mental health （ MH）, emotional functions （RE） were increased significantly （P 〈 0. 05）, and the improvements of these indexes in observation group were better than that of control group （P 〈 0. 05） ; whole blood hyposbear viscosity, whole blood middle shear viscosity, whole high blood viscosity, plasma viscosity, erythrocyte aggregation index were significantly decreased, the levels of the above indexes in observation group were lower than that in the control group （ P 〈 0.05 ）. Conclusion Ginkgo leaf tablet combined with low freauenev repetitive transcranial magnetic stimulation can significantly improve blood rheology and anxiety depression, promote the recovery of nerve function, independent life ability and quality of life in the patients with anxiety and depression after lacunar infarction.