芪参还五胶囊联合经颅直流电刺激治疗卒中后抑郁临床研究

Clinical Study of Qishen Huanwu Capsules Combined with Transcranial Direct Current Stimulation in the Treatment of Post-Stroke Depression

目的探讨芪参还五胶囊联合经颅直流电刺激(tDCS)治疗卒中后抑郁(PSD)的临床疗效,以及对患者认知功能及5-羟色胺(5-HT)、P物质(SP)水平的影响。方法选取医院2019年10月至2020年10月收治的PSD患者80例,采用随机数字表法分为研究组和对照组,各40例。两组患者均予tDCS,治疗2周;研究组患者加用芪参还五胶囊,治疗4周。结果研究组患者的临床总有效率为97.50%,显著高于对照组的77.50%(χ^(2)=7.31,P<0.05)。治疗后,两组患者汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)评分均较治疗前显著降低(P<0.05),且研究组显著低于对照组(P<0.05);两组患者的Barthel指数评分量表(BI)及简易精神状态检查量表(MMSE)评分均较治疗前显著升高(P<0.05),且研究组患者显著高于对照组(P<0.05);两组患者的全血低切黏度、全血高切黏度、血浆黏度、血小板吸附率、纤维蛋白原及血沉水平均较治疗前显著降低(P<0.05),且研究组显著低于对照组(P<0.05);两组患者的5-HT水平均显著升高,SP水平均显著降低(P<0.05),且研究组变化更显著(P<0.05)。研究组不良反应发生率为5.00%,显著低于对照组的27.50%(χ^(2)=6.28,P<0.05)。结论芪参还五胶囊联合tDCS治疗PSD的临床疗效确切,可改善患者的焦虑、抑郁情绪,以及认知功能和日常生活能力,上调5-HT水平,降低SP水平。

ObjectiveTo investigate the clinical efficacy of Qishen Huanwu Capsules combined with transcranial direct current stimulation(tDCS) in the treatment of post-stroke depression(PSD),and its effects on the cognitive function,5-hydroxytryptamine(5-HT) and substance P(SP) levels of patients.MethodsA total of 80 patients with PSD admitted to the hospital from October 2019 to October 2020 were selected and divided into the study group and the control group by the random number table method,with 40 cases in each group. The patients in the two groups were given the tDCS for two weeks,on this basis,the patients in the study group were treated with Qishen Huanwu Capsules for four weeks.ResultsThe total effective rate in the study group was 97. 50%,which was significantly higher than 77. 50% in the control group (χ^(2)= 7. 31,P < 0. 05). After treatment,the scores of Hamilton Anxiety Scale(HAMA) and Hamilton Depression Scale(HAMD) in the two groups were significantly lower than those before treatment(P < 0. 05),and those in the study group were significantly lower than those in the control group(P < 0. 05). After treatment,the scores of Barthel index(BI) and Mini-Mental State Examination(MMSE) in the two groups were significantly higher than those before treatment(P < 0. 05),and those in the study group were significantly higher than those in the control group(P < 0. 05). After treatment,the whole blood low-shear viscosity,whole blood high-shear viscosity,plasma viscosity,platelet adsorption rate,fibrinogen and erythrocyte sedimentation rate in the two groups were significantly lower than those before treatment(P < 0. 05),and those in the study group were significantly lower than those in the control group(P < 0. 05). After treatment,the 5-HT level in the two groups was significantly higher than that before treatment,the SP level in the two groups was significantly lower than that before treatment(P < 0. 05),and the above indexes in the study group changed more significantly than those in the control group(P < 0. 05). The incidence of adverse reactions in the study group was5. 00%,which was significantly lower than 27. 50% in the control group (χ^(2)= 6. 28,P < 0. 05).ConclusionQishen Huanwu Capsules combined with tDCS is effective in the treatment of PSD,which can improve the anxiety,depression,cognitive function,activity of daily living,increase the 5-HT level and decrease the SP level of patients.