乌灵胶囊联合西药治疗脑卒中抑郁患者临床疗效及对患者血清炎性反应因子和NPY的影响

Clinical Efficacy of Wuling Capsule Combined with Western Medicine in the Treatment of Stroke Depression and Its Effects on Serum Inflammatory Factors and NPY

目的:探讨乌灵胶囊联合西药治疗脑卒中后抑郁患者临床疗效及对患者血清炎性反应因子和神经肽Y(NPY)的影响。方法:选取2014年12月至2016年12月北京大学国际医院收治的脑卒中后抑郁患者98例,按照随机表法分为观察组49例与对照组49例。对照组采用盐酸舍曲林治疗,观察组在对照组基础上结合乌灵胶囊治疗。2组疗程均为8周。比较2组治疗疗效,治疗前后HAMD评分、NIHSS评分、血清炎性反应因子和NPY水平变化,及不良反应情况。结果:观察组治疗总有效率(91.84%)高于对照组(73.47%)(P<0.05)。2组治疗后HAMD评分和NIHSS评分降低(观察组:t=31.1627、17.5090,对照组:t=24.2748、9.2482,P<0.05);观察组治疗后HAMD评分和NIHSS评分低于对照组(t=10.2514、8.4123,P<0.05)。对照组治疗后血清IL-6、IL-8和TNF-α水平无明显变化(t=0.8293、0.8261、0.7223,P>0.05);观察组治疗后血清IL-6、IL-8和TNF-α水平降低(t=9.8965、15.8601、13.7221,P<0.05);观察组治疗后血清IL-6、IL-8和TNF-α水平低于对照组(t=8.4032、15.5007、13.2612,P<0.05)。对照组治疗后NPY水平无明显变化(t=0.7242,P>0.05);观察组治疗后NPY水平增加(t=9.8646,P<0.05);观察组治疗后NPY水平高于对照组(t=8.5904,P<0.05)。结论:乌灵胶囊联合西药治疗脑卒中后抑郁患者临床疗效明显,可降低炎性反应因子IL-6、IL-8和TNF-α水平,及提高NPY水平,且不良反应少,故而具有重要研究价值,值得进一步推广应用。

Objective： To investigate the clinical efficacy of Wuling capsule combined with western medicine in the treatment of post-stroke depression and the influence of serum inflammatory factors and neuropeptide Y（ NPY） on the patients. Methods： A total of 9. 8 patients with post-stroke depression treated in our hospital from December 2014 to December 2016 were randomly divided into an observation group（ 49 cases） and a control group（ 49 cases）. The control group was treated with sertraline hydrochloride,and the observation group was treated with Wuling Capsule on the basis of the control group. The two groups were treated for. 8 weeks. The therapeutic effects of the two groups were compared before and after treatment,and HAMD score,NIHSS score,serum inflammatory factors and NPY levels,and adverse reactions were observed. Results： The total effective rate of the observation group（ 91. 84%） was higher than that of the control group（ 73. 47%）（ P 〈0. 05）. The HAMD score and NIHSS score decreased in two groups after treatment（ observation group： t = 31. 1627,17. 5090,the control group： t = 24. 274. 8,9. 24. 82,P 〈0. 05）;HAMD score and NIHSS score of the observation group were lower than the control group（ t = 10. 2514,. 8. 4123,P〈 0. 05） after treatment. No obvious change of serum IL-6,IL-. 8 and TNF-α levels in control group were found（ t = 0. 8293,0. 8261,0. 7223,P 〉0. 05） after treatment; the serum IL-6,IL-. 8 and TNF-α levels decreased after treatment in observation group（ t = 9. 8965,15. 8601,13. 7221,P〈 0. 05）; the serum IL-6,IL-. 8 and TNF-α levels after treatment in the observation group were lower than in the control group（ t =. 8. 4032,15. 5007,13. 2612,P 〈0. 05）. The level of NPY in the control group did not change significantly after treatment（ t = 0. 7242,P〈 0. 05）; the level of NPY in the observation group increased（ t = 9. 8646,P 〈0. 05）; after treatment,the level of NPY in the observation group was higher than that in the control group（ t =. 8. 5904,P 〈0. 05）. Conclusion： The clinical efficacy of Wuling capsule combined with western medicine in the treatment of patients with depression after stroke is significant,which can reduce the inflammatory cytokines IL-6,IL-. 8 and TNF-levels,and increase the level of NPY,with few adverse reactions,so it has important research value,and is worth popularizing.