培元涤痰开郁方联合调督通脑针刺对痰瘀证缺血性卒中后抑郁的临床效果分析

Clinical Application of Peiyuan Ditan Kaiyu Recipe(培元涤痰开郁方)Combined with Regulating Du Meridian and Dredging Brain Acupuncture on Post-Stroke Depression after Ischemic Stroke with Phlegm and Blood Stasis Syndrome

目的探究培元涤痰开郁方联合调督通脑针刺对痰瘀证缺血性卒中后抑郁的临床治疗效果。方法选取医院收治的痰瘀证缺血性卒中后抑郁患者120例,随机分为对照组及观察组,每组60例。两组患者均给予常规治疗,对照组给予盐酸氟西汀分散片治疗,观察组给予培元涤痰开郁方联合调督通脑针刺治疗,两组疗程均为6周,对比两组临床治疗效果,并分别在治疗第3周、第6周后对比汉密尔顿抑郁量表(hamilton depression scale,HAMD)评分、美国国立卫生研究院卒中量表(the National Institutes of Health stroke scale,NIHSS)评分、血清5-羟色胺(5-hydroxytryptamine,5-HT)、去甲肾上腺素(noradrenaline,NE)水平及巴氏指数(Brarthel index,BI)评分。结果治疗6周后,对照组总有效率(83.33%,50/60)显著低于观察组96.67%(58/60)(P<0.05)。两组患者在治疗3周及6周后,HAMD评分均显著低于治疗前(P<0.05);观察组HAMD评分在治疗3周及6周后,相比对照组评分明显更低(P<0.05)。两组患者NIHSS评分在治疗3周及6周后,均较治疗前显著降低(P<0.05);同时观察组在治疗3周及6周时NIHSS评分均较对照组更低(P<0.05)。两组患者治疗3周及6周后血清5-HT及NE水平均较治疗前显著提高(P<0.05),同时观察组在治疗3周及治疗6周后血清5-HT及NE水平也比对照组有更明显的提高(P<0.05)。两组患者Barthel指数在治疗3周及6周后,均较治疗前显著升高(P<0.05);同时观察组在治疗3周及6周时Barthel指数均较对照组有更显著提升(P<0.05)。结论培元涤痰开郁方联合调督通脑针刺能够显著提高痰瘀证缺血性卒中后抑郁患者的临床治疗效果,改善患者抑郁情况,并促进卒中后神经功能的恢复,提高血清5-HT及NE水平,提升患者生存质量。

Objective To explore the clinical effect of Peiyuan Ditan Kaiyu Recipe(培元涤痰开郁方)combined with regula⁃ting Du meridian and dredging brain acupuncture on post-stroke depression of ischemic stroke with phlegm and blood stasis syn⁃drome.Methods A total of 120 patients with post-stroke depression with phlegm and blood stasis syndrome treated in the hospi⁃tal were selected and randomly divided into a control group and an observation group,60 cases in each group.Convention treat⁃ments were given in both groups.The control group was given fluoxetine hydrochloride dispersible tablets and the observation group was given Peiyuan Ditan Kaiyu Recipe combined with regulating Du meridian and dredging brain acupuncture.Both sets of treatments were 6 weeks long.The treatment effect of two groups was compared.The Hamilton depression scale(HAMD)score,the National Institutes of Health stroke scale(NIHSS)score,5-hydroxytryptamine(5-HT),noradrenaline(NE)and Barthel in⁃dex(BI)were compared after 3 and 6 weeks of treatment.Results After 6 weeks of treatment,the total effective rate of the control group was 83.33%(50/60),significantly lower than that(96.67%,58/60)of the observation group(P<0.05).After 3 and 6 weeks of treatment,the HAMD scores of the two groups were significantly lower than those before treatment(P<0.05).The HAMD score of the observation group was significantly lower than that of the control group after 3 and 6 weeks of treatment(P<0.05).NIHSS scores of patients in both groups after 3 and 6 weeks of treatment were significantly lower than those before treat⁃ment(P<0.05).At the same time,the NIHSS score of the observation group was lower than that of the control group after 3 and 6 weeks of treatment(P<0.05).The levels of serum 5-HT and NE in the two groups were significantly higher than those be⁃fore treatment after 3 and 6 weeks of treatment(P<0.05)and the levels of serum 5-HT and NE in the observation group were also significantly higher than those in the control group after 3 and 6 weeks of treatment(P<0.05).The BI values of patients in both groups increased significantly after 3 and 6 weeks of treatment(P<0.05).At the same time,the BI value of the observation group was significantly higher than that of the control group after 3 and 6 weeks of treatment(P<0.05).Conclusion Peiyuan Di⁃tan Kaiyu Recipe combined with regulating Du meridian and dredging brain acupuncture can significantly improve the clinical effect of post-stroke depression in ischemic stroke patients with phlegm and blood stasis syndrome,relieve the depression state,promote the recovery of neurological function after stroke,and increase serum levels of 5-HT and NE and improve the quality of life of patients.