解郁清心配方颗粒联合帕罗西汀治疗老年卒中后抑郁临床观察

Clinical Observation of Jieyu Qingxin Formula Granules Combined with Paroxetine in the Treatment of Elderly Patients with Post-Stroke Depression

目的探讨解郁清心配方颗粒联合帕罗西汀治疗老年卒中后抑郁(PSD)的临床疗效,以及对患者血清脑源性神经营养因子(BDNF)、同型半胱氨酸(HCY)水平的影响。方法选取医院2018年6月至2019年12月收治的老年PSD患者120例,按随机数字表法分为对照组和观察组,各60例。两组患者均予抗血小板聚集、稳定斑块等对症治疗,口服盐酸帕罗西汀片,观察组患者加服解郁清心配方颗粒,两组均持续治疗8周。结果观察组总有效率为86.67%,显著高于对照组的78.33%(P<0.05);治疗后,观察组患者的汉密尔顿抑郁量表评分、郁证积分及血清HCY水平均显著低于对照组(P<0.05),血清BDNF水平显著高于对照组(P<0.05)。结论解郁清心配方颗粒联合帕罗西汀治疗老年PSD,可改善患者的抑郁程度,其机制可能与调节BDNF及HCY的水平有关。

Objective To investigate the clinical efficacy of Jieyu Qingxin Formula Granules in the treatment of elderly patients with post-stroke depression(PSD)and the effect on the levels of serum brain-derived neurotrophic factor(BDNF)and homocysteine(HCY).Methods A total of 120 elderly patients with PSD admitted to our hospital from June 2018 to December 2019 were selected and divided into the control groups and the observation group by the random number table method,60 cases in each group.The patients in the two groups were treated with antiplatelet aggregation,stable plaque and other symptomatic treatment,and Paroxetine Hydrochloride Tablets,on this basis,the patients in the observation group were treated with Jieyu Qingxin Formula Granules.Both groups were continuously treated for eight weeks.Results The total effective rate of the observation group was 86.67%,which was significantly higher than78.33%of the control group(P<0.05).After treatment,the Hamilton Depression Scale(HAMD)score,depression syndrome score and serum HCY level in the observation group were significantly lower than those in the control group(P<0.05),and the serum BDNF level in the observation group was significantly higher than that in the control group(P<0.05).Conclusion Jieyu Qingxin Formula Granules combined with paroxetine in the treatment of elderly patients with PSD can improve the degree of depression,and its mechanism may be related to the regulation of BDNF and HCY levels.