益气活血解郁方治疗气虚血瘀肝郁型中风后抑郁症患者的临床观察

Clinical Efficacy of Yiqi Huoxue Jieyu Formula in the Treatment of Post-stroke Depression with Qi Deficiency,Blood Stasis,and Liver Qi Stagnation Syndrome

目的 探讨益气活血解郁方治疗气虚血瘀,肝郁气滞型的中风后抑郁症(Post-stroke depression, PSD)临床效果。方法 选取2015年3月—2017年2月期间在浙江大学医学院附属第二医院中医门诊、浙江中医药大学附属第二医院中医门诊和神经内科就诊的气虚血瘀、肝郁气滞型PSD患者156例,按照随机数字表法分为西药氟西汀对照组、益气活血解郁方中医治疗组、中西医结合治疗组,每组各52例。治疗1个月后,观察比较3组患者临床总有效率、愈显率、中医证候临床疗效,治疗前后HAMD评分。结果 治疗后3组患者HAMD评分均较治疗前降低,差异有统计学意义(P<0.05);且中西医结合治疗组HAMD评分较对照组、中医治疗组明显降低,差异有统计学意义(P<0.05)。治疗后3组患者总有效率比较,差异无统计学意义(P>0.05)。治疗后对照组、中医治疗组、中西医结合治疗组愈显率(治愈和显效)分别为48.08%(25/52)、51.92%(27/52)、73.08%(38/52),中西医结合治疗组愈显率明显优于对照组、中医治疗组,差异有统计学意义(P<0.05)。治疗后对照组、中医治疗组、中西医结合治疗组中医证候临床疗效总有效率分别为69.23%(36/52)、75.00%(39/52)、86.54%(45/52),中西医结合治疗组总有效率明显优于对照组、中医治疗组,差异有统计学意义(P<0.05)。结论 益气活血解郁方可有效治疗气虚血瘀肝郁型PSD。

Objective To explore the clinical efficacy of Yiqi Huoxue Jieyu Formula(YQHXJY)in the treatment of post-stroke depression(PSD)with qi deficiency,blood stasis,and liver qi stagnation syndrome.Methods A total of 156 patients with PSD of qi deficiency,blood stasis,and liver qi stagnation syndrome treated in the TCM Department of the Second Affiliated Hospital of School of Medicine,Zhejiang University,and TCM Department and Department of Neurology of the Second Affiliated Hospital of Zhejiang Chinese Medical University from March 2015 to February 2017 were enrolled and divided into a western medicine group(fluoxetine),a TCM group(YQHXJY),and an integrated TCM and western medicine group,with 52 cases in each group according to the random number table method.After one month of treatment,the clinical total effective rate,the cured and markedly effective rate,the clinical efficacy of TCM syndrome,and the HAMD score before and after treatment were observed and compared among the three groups.Results After treatment,the HAMD scores of the three groups were lower than those before treatment(P<0.05).Moreover,the HAMD score in the integrated TCM and western medicine group was lower than that in the western medicine group and the TCM group(P<0.05).After treatment,there was no significant difference in the total effective rate among the three groups(P>0.05).After treatment,the cured and markedly effective rates of the western medicine group,the TCM group,and the integrated TCM and western medicine treatment group were 48.08%(25/52),51.92%(27/52),and 73.08%(38/52),respectively.The cured and markedly effective rate of the integrated TCM and western medicine treatment group was superior to that of the western medicine group and the TCM group(P<0.05).After treatment,the total effective rates of clinical efficacy of TCM syndrome in the western medicine group,the TCM group,and the integrated TCM and western medicine group were 69.23%(36/52),75.00%(39/52),and 86.54%(45/52),respectively,indicating that the integrated TCM and western medicine group was superior to the western medicine group and the TCM group(P<0.05).Conclusion YQHXJY can effectively treat PSD with qi deficiency,blood stasis,and liver qi stagnation syndrome.