养血益脑方联合黛力新治疗脑卒中后抑郁临床研究

Effect of Yangxue Yinao Decoction Combined with Deanxit on Patients with Depression after Stroke

目的：探讨养血益脑方联合黛力新治疗脑卒中后抑郁（PSD）患者的临床疗效和安全性。方法：选取2014年3月—2016年2月在杭州市红十字会医院神经内科住院治疗的脑卒中后抑郁患者104例,随机将患者分为两组,每组各52例,对照组给予口服黛力新,观察组在对照组基础上给予养血益脑方剂,连续治疗8周。采用汉密尔顿抑郁量表（HAMD）对患者治疗前和治疗后2、4、8周抑郁状态进行评估;使用ELISA法测定血清肿瘤坏死因子α（TNFα）、白细胞介素6（IL-6）、白细胞介素8（IL-8）和超敏C反应蛋白（hs-CRP）等炎症相关指标;记录患者治疗过程中发生的不良反应。结果：两组患者治疗前HAMD抑郁量表评分无明显差异（P〉0.05）,治疗2、4、8周后评分比治疗前明显降低（P〈0.05）;观察组在治疗的第2、4、8周末抑郁评分均明显低于对照组（P〈0.05-P〈0.001）;观察组在第2、4、8周末的治疗总体有效率分别为77%、90%、96%,明显高于对照组的62%、73%、83%（P〈0.05）;两组患者的不良反应均较轻,观察组患者失眠发生率为1.9%,明显低于对照组的13.5%（P〈0.05）,其他不良反应发生率两组间无统计学差异（P〉0.05）。结论：养血益脑方联合黛力新治疗脑卒中后抑郁,可降低HAMD抑郁评分、减轻炎症水平,临床疗效明显优于单用黛力新,且未见不良反应增加,值得临床进一步推广。

Objective： To investigate the clinical advantages and salty of Yangxue Yinao Decoction combined with deanxit treatment on patients with post - stroke depression. Meathods ： A total of 104 patients with post - stroke depres- sion, admitted to Hangzhou Red Cross Hospital from March 2014 to February 2016, were randomly divided into control group and observation group, 52 patients in each group. The control goup were orally administrated deanxit for 8 weeks, while the observation group were given Yangxue Yinao Decoction on the basis of the control group. The depression de- grees of the patients were evaluated before treatment, and 2,4,8 weeks after treatment by Hamilton Depression Rating Scale. Inflammatory cytokines in serum such us TNFα, IL - 6, IL - 8 and hs - CRP were detected by ELISA. And all the adverse reactions occurred during the treatment were recorded. Results ： Depression of patients in both groups was sig- nificantly improved after 2,4,8 weeks treatment with a significantly decrease in HAMD scores （P 〈 0. 05 ）, and the HAMD scores of the observation group were obviously lower than that of the control group（ P 〈0. 05 ,P 〈0. 001 ）. The to- tal effective rates in the control group in 2,4,8 weeks（77%, 90%, 96% ） were significantly higher than that in the con- trol group（62% ,73 % ,83 % ） （P 〈 O. 05 ）. Two groups have a lower incidence of adverse reactions. The incidence of in- somnia in observation group was significantly lower than that of the control group （1.9% vs 13.5%, P 〈 0. 05 ）, and other adverse reactions had no statistical difference between the two groups （ P 〉 O. 05 ）. Conclusion ： Yangxue Yinao De- coction combined with deanxit can effectively reduce the HAMD scores, alleviate inflammation, and shows superior clini- cal effect without increased adverse reactions.