丹栀逍遥散联合艾司西酞普兰治疗血管性痴呆伴抑郁的疗效观察

Effect of Danzhi Xiaoyao Powder combined with escitalopram in the treatment of vascular dementia with depression

目的 观察丹栀逍遥散联合艾司西酞普兰治疗血管性痴呆(VD)伴抑郁患者的疗效。方法 选取2019年10月至2021年10月于中国人民解放军联勤保障部队第九八七医院神经内科就诊的VD患者98例,采用随机数表法分为观察组和对照组,每组49例。对照组患者接受艾司西酞普兰治疗,观察组患者接受丹栀逍遥散联合艾司西酞普兰治疗,均连续治疗8周。比较两组患者的临床疗效,治疗前后的抑郁状态[采用康奈尔痴呆抑郁量表(CSDD)评估]、认知功能[采用简易智能精神状态评估量表(MMSE)评估]和生活质量[采用健康测量量表(SF-36)评估]以及治疗期间的不良反应发生情况。结果 研究期间,对照组4例患者脱落,最终纳入观察组49例,对照组45例;观察组患者的治疗总有效率为91.84%,明显高于对照组的75.56%,差异有统计学意义(P<0.05);治疗后4周、8周,观察组患者的CSDD评分分别为(13.15±3.64)分、(8.07±2.57)分,明显低于对照组的(14.86±4.18)分、(9.41±2.43)分,差异均有统计学意义(P<0.05);治疗后8周,观察组患者的MMSE评分为(25.91±7.49)分,明显高于对照组的(22.17±7.25)分,差异有统计学意义(P<0.05);治疗后4周、8周,观察组患者的SF-36评分分别为(623.46±26.31)分、(655.72±22.56)分,明显高于对照组的(610.73±21.85)分、(632.19±31.34)分,差异均有统计学意义(P<0.05);治疗期间,观察组和对照组患者的总不良反应发生率分别为18.37%、28.89%,差异无统计学意义(P>0.05)。结论 丹栀逍遥散联合艾司西酞普治疗VD伴抑郁患者疗效显著,其在改善患者抑郁状态的同时,能提高其认知功能,且总体耐受性良好。

Objective To observe the effect of Danzhi Xiaoyao Powder combined with escitalopram in the treatment of patients with vascular dementia(VD) and depression. Methods A total of 94 patients with VD who were treated in the Department of Neurology, 987 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army from October 2019 to October 2021 were selected and divided into an observation group and a control group according to the random number table method, with 49 patients in each group. The patients in the control group were treated with escitalopram, and those in the observation group were treated with Danzhi Xiaoyao Powder combined with escitalopram, both for 8 weeks. Clinical effects in the two groups were comparatively analyzed. The Cornell Scale for Depression in Dementia(CSDD), Mini-Mental State Examination(MMSE), and 36-item Short-Form(SF-36) were used to evaluate depressive state, cognitive function, and quality of life, respectively. The occurrence of adverse reactions during treatment was recorded. Results There were 4 patients lost to follow up in the control group. Finally, there were 49patients in the observation group and 45 patients in the control group. The total treatment response rate in the observation group was 91.84%, significantly higher than 75.56% in the control group(P<0.05). At 4 and 8 weeks after treatment, the CSDD scores of the observation group were lower than those of the control group:(13.15±3.64) points vs(14.86±4.18) points,(8.07±2.57) points vs(9.41±2.43) points, both P<0.05. At 8 weeks after treatment, the MMSE score of the observation group was significantly higher than that of the control group:(25.91±7.49) points vs(22.17±7.25) points, P<0.05. At 4 and 8 weeks after treatment, the SF-36 scores of the observation group were higher than those of the control group:(623.46±26.31) points vs(610.73±21.85) points,(655.72±22.56) points vs(632.19±31.34) points,both P<0.05. There was no significant difference between the two groups in the incidence of adverse reactions during treatment(18.37% vs 28.89%, P>0.05). Conclusion Danzhi Xiaoyao Powder combined with escitalopram is effective in the treatment of patients with VD and depression, which can improve the patients’ depressive state and cognitive function, with good tolerance.