黄连温胆汤治疗卒中后抑郁症的前瞻性随机对照研究

Prospective Randomized Controlled Study of Huanglian Wendan Decoction(黄连温胆汤)in Treatment of post-stroke Depression

目的探讨卒中后抑郁症患者采用黄连温胆汤治疗的临床效果及对认知功能和生活质量的影响。方法选取80例2019年5月—2022年5月医院收治的卒中后抑郁患者作为研究对象,根据随机数字表法将其分为观察组(40例)和对照组(40例)。对照组予以常规对症治疗,观察组则在此基础上联合黄连温胆汤加味内服治疗。两组患者均连续治疗8周。比较两组患者治疗后的临床疗效,治疗前后的汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、简易精神状态检查(mini-mental state examination,MMSE)、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、不良反应量表(treatment emergent symptom scale,TESS)、改良Barthel指数(modified Barthel index,MBI)、生活质量评分、血清去甲肾上腺素(norepinephrine,NE)、多巴胺(dopamine,DA)、5-羟色胺(5-hydroxytryptamine,5-HT)水平。结果治疗后观察组临床总有效率高于对照组;与治疗前比较,治疗后两组HAMD、HAMA、PSQI、NIHSS、TESS评分均降低,且观察组低于对照组;两组MMSE、MBI、生活质量各维度评分、血清NE、DA、5-HT水平均逐渐升高,且组间进行比较,观察组更高,差异有统计学意义(P<0.05)。结论黄连温胆汤应用于卒中后抑郁症患者的治疗中可有效缓解患者的焦虑、抑郁症状,提升睡眠质量,明显减轻神经功能和认知功能的损伤,有效促进神经递质水平的调节,使患者生活质量和日常生活活动能力明显提升,疗效显著且安全性高。

Objective To investigate the clinical effect of Huanglian Wendan Decoction(黄连温胆汤)in the treatment of post-stroke depression and its influence on cognitive function and quality of life.Methods Eighty patients with post-stroke depression admitted to the hospital from May 2019 to May 2022 were selected and divided into the observation group and the control group according to random number table method,with 40 cases in each group.The control group was treated with conventional symptomatic treatment,and the observation group was treated with Huanglian Wendan Decoction.Both groups were treated for 8 weeks.The clinical efficacy after treatment,Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),Pittsburgh sleep quality index(PSQI),mini-mental state examination(MMSE),National Institute of Health stroke scale(NIHSS),treatment emergent symptom scale(TESS),modified Barthel index(MBI),quality of life,serum levels of norepinephrine(NE),dopamine(DA)and 5-hydroxytryptamine(5-HT)before and after treatment of the two groups were compared.Results The total effective rate of the observation group was higher than that of the control group.Compared with those before treatment,HAMD,HAMA,PSQI,NIHSS and TESS scores of the two groups decreased after treatment,and the scores of the observation group were lower than those of the control group.MMSE,MBI and scores of all dimensions of quality of life,serum levels of NE,DA and 5-HT increased in two groups,and compared between groups,the levels of observation group were higher,,the difference was statistically significant(P<0.05).Conclusion Huanglian Wendan Decoction applied in the treatment of patients with post-stroke depression can effectively alleviate the anxiety and depression symptoms of patients,improve sleep quality,significantly reduce the damage of neurological function and cognitive function,effectively promote the regulation of neurotransmitter levels,and help patients significantly improve their quality of life and ability of daily living activities,with significant efficacy and high safety.