中西医结合治疗缺血性卒中后抑郁42例疗效观察

Clinical Observation on 42 Cases of Post-Ischemic Stroke Depression Treated by Integrated Traditional Chinese and Western Medicine

目的:观察扶阳涤痰解郁汤联合草酸艾司西酞普兰对缺血性卒中后抑郁的临床疗效以及对甲状腺激素水平的干预作用,并探讨卒中后抑郁症状与甲状腺激素水平的相关性。方法:81例符合纳入标准的受试者随机分为对照组39例、观察组42例,对照组给予草酸艾司西酞普兰治疗;观察组在对照组基础上联用扶阳涤痰解郁汤治疗,观察两组治疗前后HAMD抑郁量表、NIHSS神经功能缺损评分、临床疗效及对甲状腺激素的影响,并分析甲状腺激素与HAMD、NIHSS评分的相关性。结果:经8周治疗后,对照组HAMD及NIHSS评分及差值与观察组比较有显著性差异(P<0.05,P<0.01),治疗后对照组及观察组T4、T3水平均较治疗前明显下降,组内比较有统计学意义(P<0.01),观察组的FT4水平组间比较有统计学意义(P<0.05),对照组总有效率为69.23%,观察组为88.10%,组间比较差异有统计学意义(P<0.05)。结论:扶阳涤痰解郁汤联合草酸艾司西酞普兰有效改善缺血性卒中后抑郁患者的抑郁情绪及神经功能缺损程度,同时可积极调节甲状腺激素水平,有效减少后续相关症状的发生。

Objective In order to observe the clinical effect of Fuyang Ditan Jieyu Decoction Combined with escitalopram oxalate on post-stroke depression and the intervention effect on thyroid hormone level,and to explore the correlation between post-stroke depression symptoms and thyroid hormone level.Methods According to the inclusion criteria,patients with post-stroke depression were randomly divided into the control group(39 cases)and the observation group(42 cases).The control group was treated with escitalopram oxalate,while the observation group was treated with Fuyang Ditan Jieyu Decoction on the basis of the control group.The HAMD depression scale,NIHSS neurological deficit score,clinical efficacy and the impact on thyroid hormone were observed before and after treatment in the two groups,and the relationship between thyroid hormone and HAMD,NIHSS and thyroid hormone were analyzed Correlation of NIHSS score.Results After 8 weeks of treatment,the scores and differences of HAMD and NIHSS in the observation group were significantly better than those in the control group(P<0.05,P<0.01).After treatment,the levels of T4 and T3 in the two groups were significantly lower than those before treatment,with statistical significance(P<0.01).The level of FT4 in the observation group was statistically significant(P<0.05).The total effective rate in the control group was 69.23%,and that in the observation group was 88.10%,with statistical significance(P<0.05).Conclusions Fuyang Ditan Jieyu Decoction Combined with escitalopram oxalate can effectively improve the degree of depression and neurological impairment in patients with depression after ischemic stroke,and can positively regulate the level of thyroid hormone,effectively reduce the occurrence of subsequent related symptoms.