逐瘀醒脑丸对脑卒中后抑郁(气虚血瘀证)患者的影响

The Impact of Zhubi Xingnao Pills on Patients with Post-Stroke Depression(Qi Deficiency and Blood Stasis Syndrome)

目的探究逐瘀醒脑丸对脑卒中后抑郁(气虚血瘀证)患者的影响。方法选择2020年12月至2022年12月期间在南阳张仲景医院治疗的98例脑卒中后抑郁患者,以随机数表法将其分为对照组(n=49)及观察组(n=49),两组均进行常规治疗,对照组加以艾司西酞普兰治疗,观察组给予艾司西酞普兰联合逐瘀醒脑丸治疗,对比两组治疗有效率、汉密尔顿抑郁量表(HAMD)、美国国立卫生研究院卒中量表(NIHSS)、脑源性神经营养因子(BDNF)、血管内皮生长因子(VEGF)、神经生长因子(NGF)、神经元特异性烯醇化酶(NSE)、核因子E2相关因子(Nrf2)、血红素加氧酶-1(HO-1)、5-羟色胺(5-HT)、去甲肾上腺素(NE)、血清氨基酸类神经递质γ-氨基丁酸(GABA)、谷氨酸(Glu)、天冬氨酸(Asp)、不良反应发生率。结果观察组治疗有效率(95.92%)高于对照组(73.47%),差异具有统计学意义(P<0.05)。治疗后观察组HAMD、NIHSS评分低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组BDNF、NGF、VEGF水平高于对照组,NSE水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组Nrf2、HO-1、5-HT、NE水平高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组GABA水平高于对照组,Glu、Asp水平低于对照组,差异具有统计学意义(P<0.05)。观察组不良反应发生率(2.04%)低于对照组(26.53%),差异具有统计学意义(P<0.05)。结论逐瘀醒脑丸治疗脑卒中后抑郁效果显著,可改善血管内皮功能,调节神经营养因子水平,提高抗氧化应激能力,调节单胺类和氨基酸类神经递质含量,改善病情。

Objective To explore the impact of Zhubi Xingnao Pills on patients with post-stroke depression(Qi Deficiency and Blood Stasis Syndrome).Methods 98 patients with post-stroke depression treated in Nanyang Zhang Zhongjing Hospital from December 2020 to December 2022 were selected and divided into control group(n=49)and observation group(n=49)by random number table method.Both groups received routine treatment.The control group was treated with escitalopram,and the observation group was treated with escitalopram combined with Zhubi Xingnao Pills.The treatment effectiveness,Hamilton Depression Scale(HAMD),National Institutes of Health Stroke Scale(NIHSS),Brain-Derived Neurotrophic Factor(BDNF),Vascular Endothelial Growth Factor(VEGF),Nerve Growth Factor(NGF),Neuron-Specific Enolase(NSE),Nuclear Factor E2-Related Factor(Nrf2),Heme Oxygenase-1(HO-1),5-Hydroxytryptamine(5-HT),Norepinephrine(NE),serum amino acid neurotransmittersγ-Aminobutyric Acid(GABA),Glutamate(Glu),Aspartate(Asp),and adverse reaction rate were compared between the two groups.Results The treatment effectiveness rate(95.92%)of the observation group was higher than that of the control group(73.47%),and the difference was statistically significant(P<0.05).After treatment,the HAMD and NIHSS scores of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of BDNF,NGF,and VEGF in the observation group were higher than those in the control group,and the level of NSE was lower than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of Nrf2,HO-1,5-HT,and NE in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the level of GABA in the observation group was higher than that in the control group,and the levels of Glu and Asp were lower than those in the control group,and the difference was statistically significant(P<0.05).The adverse reaction rate(2.04%)of the observation group was lower than that of the control group(26.53%),and the difference was statistically significant(P<0.05).Conclusion Zhubi Xingnao Pills have a significant effect on the treatment of post-stroke depression,can improve vascular endothelial function,regulate the level of neurotrophic factors,enhance antioxidant stress ability,regulate the content of monoamine and amino acid neurotransmitters,and improve the condition.