丹栀温胆汤联用艾司西酞普兰治疗脑卒中后抑郁临床研究

Clinical Study of Post-Stroke Depression Treated with Danzhi Wendan Decoction Combined with Escitalopram

目的 :观察丹栀温胆汤加减联用艾司西酞普兰对脑卒中后抑郁(PSD)患者的临床疗效及安全性。方法 :选取确诊患者76例,按先后顺序分为治疗组和对照组各38例,治疗组用丹栀温胆汤加减联用艾司西酞普兰治疗,对照组单用艾司西酞普兰治疗,共观察6周。采用汉密尔顿抑郁量表(HAMD)在治疗前及治疗后第2周、4周、6周末评分以评定疗效,采用美国国立卫生研究院卒中量表(NIHSS)评分评定神经功能缺损程度,不良反应量表(TESS)评分评定不良反应。结果:治疗6周后,治疗组与对照组总有效率分别为92.11%和73.68%,两组间比较差异有统计学意义(P<0.05)。两组均能快速改善患者的抑郁症状,自第2周末起HAMD评分显著低于治疗前(P<0.01),但治疗组6周末HAMD评分显著低于对照组(P<0.05);治疗组自第4周末NIHSS评分显著高于对照组(P<0.01),两组TESS量表评分比较差异无统计学意义(P>0.05)。结论:丹栀温胆汤加减联用艾司西酞普兰治疗脑卒中后抑郁可显著改善患者的神经功能,疗效可靠,安全性高且不良反应小。

Objective：To observe the clinical efficacy and safety of Danzhi Wendan decoction combined with escitalopram in treatment for patients with post-stroke depression. Methods：A total of 76 patients with post-stroke depression were randomly allocated to a treatment group and a control group,with 38 in each group. The treatment group were treated with Danzhi Wendan decoction combined with escitalopram,while the control group were only given escitalopram. Both the two groups were observed for 6 weeks. The HAMD was used to evaluate the clinical efficacy of the two groups before and after 2,4,6 weeks of the treatment and the National Institutes of Health Stroke Scale（NIHSS） was applied to evaluate the degree of neurological deficit,adverse reactions were evaluated with TESS scale. Results：After 6 weeks of treatment,the total effective rate of the treatment group was 92.11% and the control group was 73.68%,with a statistically significant difference between the two groups（P〈0.05）. In the two groups,depressive symptoms were relieved obviously and the HAMD scores were significantly lower than those before treatment since the second week（P〈0.01）,but in the treatment group at the end of the 6 th week,the HAMD scores were significantly lower than those in the control group（P〈0.05）. In the treatment group,from the 4 th weekend NIHSS score was significantly higher than that in the control group（P〈0.01）. In the two groups,the TESS scale showed no statistically significant difference（P〉 0.05）. Conclusion：Danzhi Wendan decoction combined with escitalopram in the treatment of depression after stroke can significantly improve the neurological function,with reliable curative effect,high safety and less adverse reactions.