西医联合柴胡加龙骨牡蛎汤治疗脑卒中后抑郁患者的效果

Effect of western medicine combined with Chaihu plus Longgu Muli decoction in the treatment of patients with post-stroke depression

目的研究西医联合柴胡加龙骨牡蛎汤治疗脑卒中后抑郁患者的效果。方法选取我院2017年5月至2018年4月收治的68例脑卒中后抑郁患者作为研究对象,按照随机数字表法将其分为对照组(34例)与观察组(34例)。对照组采用西医基础治疗,观察组在对照组基础上联合柴胡加龙骨牡蛎汤治疗。比较两组患者治疗前、后的中医证候积分、抑郁评分、神经功能缺损评分、日常生活活动能力评分、血清细胞因子水平和不良反应发生情况。结果治疗后,两组的中医证候积分、HAMD、NIHSS评分均降低,Barthel指数均升高,且观察组优于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的TNF-α、IL-1β水平均降低,且观察组低于对照组(P<0.05)。观察组的不良反应总发生率明显低于对照组(P<0.05)。结论西医联合柴胡加龙骨牡蛎汤治疗脑卒中后抑郁患者能够有效改善抑郁症状和神经功能,提高患者的日常生活活动能力,减轻炎症反应,安全有效。

Objective To study the effect of western medicine combined with Chaihu plus Longgu Muli decoction in the treatment of patients with post-stroke depression. Methods Sixty-eight patients with post-stroke depression were admitted in our hospital from May 2017 to April 2018 were selected as the study objects. The patients were divided into control group(34 cases) and observation group(34 cases) according to the random number table method. The control group was treated with western medicine, and the observation group was treated with Chaihu plus Longgu Muli decoction on the basis of the control group. The TCM syndromes scores, depression scores, neurological deficit scores, activity of daily living scores, serum cytokine levels before and after treatment and adverse reactions were compared between the two groups.Results After treatment, the scores of TCM syndromes, HAMD and NIHSS in the two groups decreased, the Barthel indexes increased, and those of the observation group were better than the control group, the differences were statistically significant(P <0.05). After treatment, the levels of TNF-α and IL-1β in the two groups decreased, and those of the observation group were lower than the control group(P<0.05). The total incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05). Conclusion Western medicine combined with Chaihu plus Longgu Muli decoction can effectively improve depressive symptoms and nerve function in patients with post-stroke depression, it can improve patients’ daily living activities and reduce inflammation, which is safe and effective.