卒中解郁汤联合盐酸帕罗西汀治疗脑卒中后抑郁的临床疗效及对血清5-HT、IL-1、Hcy的影响

Clinical efficacy of Stroke Jieyu Decoction combined with Paroxetine Hydrochloride in the Treatment of Post-stroke Depression and its Effect on Serum 5-HT,IL-1 and Hcy

目的:探讨卒中解郁汤联合盐酸帕罗西汀治疗脑卒中后抑郁(PSD)的临床疗效及对血清5-羟色胺(5-HT)、白介素-1(IL-1)、同型半胱氨酸(Hcy)的影响。方法:选取2017年12月~2020年6月中国中医科学院望京医院收治的86例PSD患者,根据乱数表法分为两组,对照组(n=43)接受盐酸帕罗西汀治疗,观察组(n=43)接受卒中解郁汤联合盐酸帕罗西汀治疗。对比两组患者临床疗效和治疗前后中医证候积分、汉密顿抑郁量表(HAMD)及血清5-羟色胺(5~5-HT)、白介素-1(IL-1)、同型半胱氨酸(Hcy)水平、不良反应。结果:观察组治疗有效率明显高于对照组(P<0.05);治疗后观察组中医证候积分、PASI评分和血清L-1、Hcy水平明显低于对照组,血清5-HT水平明显高于对照组(P<0.05);两组患者不良反应发生率对比无差异(P>0.05)。结论:卒中解郁汤联合盐酸帕罗西汀治疗PSD疗效确切,可明显缓解抑郁症状,安全性高,其机制可能与增加神经递质含量和减轻炎性损伤有关。

Objective:To investigate the clinical efficacy of Stroke Jieyu decoction combined with paroxetine hydrochloride in the treatment of post-stroke depression(PSD)and the serum 5-hydroxytryptamine(5-HT),interleukin-1(IL-1),homocysteine(Hcy)influence.Methods:A total of 86 patients with PSD admitted to our hospital(from December 2017 to June 2020)were selected and divided into two groups according to the random number table method.The control group(n=43)received paroxetine hydrochloride treatment,and the observation group(n=43)received the treatment of Stroke Jieyu decoction combined with paroxetine hydrochloride.The clinical efficacy,TCM syndrome score,Hamilton Depression Scale(HAMD)and serum 5-hydroxytryptamine(5-HT),interleukin-1(IL-1),homocysteine(Hcy)levels and adverse reactions of the two groups were compared before and after treatment.Results:The effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05);After treatment,the TCM syndrome score,PASI score,and serum L-1 and Hcy levels of the observation group were significantly lower than those of the control group,and the serum 5-HT levels were significantly higher than those of the control group(P<0.05);There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Stroke Jieyu decoction combined with paroxetine hydrochloride has a definite effect in the treatment of PSD,it can significantly relieve depressive symptoms and has high safety,the mechanism may be related to increasing neurotransmitter content and reducing inflammatory damage.