摘要
目的:观察自拟疏肝益肾通络汤治疗脑卒中后抑郁的临床疗效。方法:将76例脑卒中后抑郁患者按随机数字表法分成观察组和对照组,每组38例。对照组采用常规西药盐酸氟西汀胶囊治疗,每次20 mg,每天1次,早餐后口服,连续用药4周。观察组在对照组治疗的基础上加用中药自拟疏肝益肾通络方治疗,药物组成:黄芪30 g,柴胡、枳壳、石菖蒲、白术、郁金、茯苓各15 g,当归、炒枣仁各20 g,甘草6 g。辨证加减用药:嗳气频繁发、脘闷者加法半夏15 g;胁肋胀痛者加青皮10 g;失眠者加龙骨、牡蛎各10 g;郁火烦躁者加牡丹皮15 g。水煎服,首煎加水500 m L,取药汁150 m L;二煎加水300 m L,取150 m L药汁,相混合,早、晚两次服用,每天1剂,连续服用4周。治疗后采用汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、日常生活能力评定量表(activity of daily living scale,ADL)评测两组治疗效果。结果:治疗前观察组HAMD评分为(28.21±1.36)分,对照组HAMD评分为(28.30±1.53)分,治疗4周后两组患者的HAMD评分均得到改善,观察组HAMD评分为(12.15±1.28)分,明显低于对照组的(17.28±1.37)分,可见观察组优于对照组,差异有统计意义(P<0.05);治疗前观察组ADL评分为(50.91±10.16)分,对照组ADL评分为(65.73±8.46)分,治疗后观察组ADL评分为(77.15±8.08)分,明显高于对照组的(65.73±8.46)分,差异有统计意义(P<0.05);观察组临床有效率为94.7%,显著高于对照组的84.2%,差异有统计意义(P<0.05);对照组不良反应发生率高于观察组,差异有统计意义(P<0.05)。结论:对脑卒中后抑郁患者采用疏肝益肾通络汤治疗疗效显著,且无明显不良反应。
Objective:To observe the clinical effect of self-made Shugan Yishen Tongluo decoction in the treatment of post-stroke depression. Methods:76 patients with post-stroke depression were randomly divided into the observation group and the control group,38 cases in each group. The control group was given conventional western medicine, Fluoxetine Hydrochloride capsules, 20 mg each time, 1 time a day, after breakfast orally for 4 weeks. The observation group was treated with self-made Shugan Yishen Tongluo decoction, composition : Huangqi ( Astragalus Membranaceus) 30 g, Chaihu ( Radix Bupleuri) 15 g, Zhike ( Fructus Auran- tii) 15 g, Shichangpu ( Acorus Gramineus) 15 g, Baizhu ( Rhizoma Atractylodis Macrocephalae) 15 g, Yujin ( Radix Curcumae) 15 g, Fuling ( Poria Cocos) 15 g, Danggui ( Angelica Sinensis ) 20 g, Chaosuanzaoren ( Semen Ziziphi Spinosae) 20 g, Gancao ( Liquo- rice) 6 g. Frequent belching, fullness, with Fabanxia ( Rhizoma Pinellinae Praeparata) 15 g, distending pain in hypochondrium, with Qingpi(Pericarpium Citri Reticulatae Viride) 10 g,insomnia with Longgu(Fossil Fragments) 10 g and Muli( Concha Ostre- ae) 10 g,suffering from the fidgets,with Mudanpi( Moutan Bark)15 g. Water decoction,taking 4 consecutive weeks. After treat-ment, Hamilton depression scale (HAMD) and activity of daily living scale (ADL) were used to evaluate the effect of the two groups. Results:Before treatment, the observation group HAMD score was (28.21 ± 1.36) points, control group HAMD score was (28.30 ± 1.53) points,after 4 weeks of treatment, HAMD scores of two groups were improved,the observation group HAMD score was ( 12.15 ± 1.28) points, significantly lower than the control group ( 17.28 ± 1.37 ) points, and the observation group better than the control group,the difference was statistically significant (P 〈 0.05 ) ;before treatment, the observation group ADL score was (50.91 ± 10.16)points, control group ADL score was (65.73 ± 8.46)points, after treatment, the observation group ADL score was (77.15 ± 8.08 )points, significantly higher than the control group (65.73 ± 8.46)points, the difference was statistically significant (P 〈 0.05 ) ;the clinical effective rate of observation group was 94.7 %, significantly higher than 84.2% in the control group ( P 〈 0.05 ) ; the adverse reaction rate of control group was higher than that of the observation group ( P 〈 0.05 ). Conclusion : Shugan Yishen Tongluo decoction treatment of patients with depression after stroke has significant effect, and no obvious adverse reactions.
出处
《中医学报》
CAS
2017年第8期1519-1522,共4页
Acta Chinese Medicine
基金
河南省中医药科研专项课题(2014ZY02060
2016ZY03004)
关键词
中风后抑郁
疏肝益肾通络汤
汉密尔顿抑郁量表
日常生活能力评定量表
中医药治疗
中西医结合
Key words:post-stroke depression
Shugan Yishen Tongluo decoction
Hamilton depression scale
activity of daily living scale
TCM therapy
combination of Chinese and Western medicine