醒脑解郁方治疗脑梗死后阈下抑郁临床观察

Clinical Observation of Xingnao Jieyu Recipe in Treating Subliminal Depression after Cerebral Infarction

目的探讨醒脑解郁方治疗脑梗死后阈下抑郁的临床效果。方法选取潍坊市中医院就诊的脑梗死后阈下抑郁患者102例,以随机数字表分为研究组、对照组各51例。对照组给予盐酸氟西汀胶囊治疗,研究组给予醒脑解郁方治疗。观察2组治疗后的临床效果,中医证候评分,抑郁自评量表(SDS)评分,汉密顿抑郁量表(HAMD)评分,美国国立卫生研究院卒中量表(NIHSS)评分,改良Barthel指数评分量表(MBI)评分,血清神经递质水平即5-羟色胺(5-HT)、多巴胺(DA)、神经生长因子(NGF)、脑源性神经营养因子(BDNF)水平,血清miR-124、miR-139-5p相对表达量。结果研究组治疗后总有效率88.24%(45/51)高于对照组的76.47%(39/51)(P<0.05);2组治疗后中医证候积分、SDS评分、HAMD评分、NIHSS评分及血清miR-124、miR-139-5p相对表达量均较治疗前降低,且研究组低于对照组(P<0.05);2组治疗后MBI评分、血清神经递质水平较治疗前升高,且研究组高于对照组(P<0.05)。结论醒脑解郁方可改善脑梗死后阈下抑郁患者临床症状,进一步防止阈下抑郁向重度抑郁转化,疗效显著。

Objective To explore the clinical observation of Xingnao Jieyu recipe in the treatment of subliminal depression after cerebral infarction.Methods A total of 102 patients with subthreshold depression after cerebral infarction in Weifang Hospital of Traditional Chinese Medicine were selected and divided into a study group and a control group based on a random number table,with 51 cases in each group.The control group was treated with fluoxetine hydrochloride capsules,and the study group was treated with Xingnao Jieyu recipe.The clinical effect of the two groups after treatment,TCM syndrome score,SDS score,HAMD score,NIHSS score,MBI score,serum neurotransmitter levels,namely 5-HT,DA,NGF,and BDNF levels,serum miR-124,miR-the relative expression level of 139-5p were observed.Results The total effective rate of the study group was 88.24%(45/51)higher than that of the control group(76.47%,39/51)(P<0.05).After treatment,TCM syndrome score,SDS score,HAMD score,NIHSS score and relative expression levels of miR-124 and miR-139-5p in serum of the 2 groups were lower than before treatment,and the study group was lower than the control group(P<0.05).After treatment,MBI score and serum neurotransmitter level in 2 groups were higher than before treatment,and the study group was higher than the control group(P<0.05).Conclusion Xingnao Jieyu recipe can improve the clinical symptoms of patients with subthreshold depression after cerebral infarction,and further prevent the transformation of subthreshold depression to severe depression,and has significant effect.