舒肝解郁胶囊联合艾司西酞普兰对脑梗死后抑郁症的影响

The Impact of Shugan Jieyu Capsules Combined with Escitalopram on Post-Stroke Depression

目的探究舒肝解郁胶囊联合艾司西酞普兰用于脑梗死后抑郁症的疗效及对血5-羟色胺(5-HT)和神经递质功率的影响。方法将2020年6月至2023年6月河南省济源市人民医院收治的脑梗死后抑郁症患者进行中医辩证分型,选取96例症属肝郁脾虚者纳入研究对象,以随机数字表法分为两组展开前瞻性研究,各48例,96例患者均接受常规治疗,对照组予以艾司西酞普兰实施治疗,观察组则基于对照组联用舒肝解郁胶囊实施治疗,比较两组治疗前后汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、美国国立卫生研究院卒中量表(NIHSS)评分、5-HT水平、神经递质功率、疗效及不良反应。结果治疗后,观察组HAMD、HAMA与NIHSS评分均显著低于对照组,差异均有统计学意义(P<0.05);治疗后,两组5-HT浓度均上升,且观察组5-HT浓度显著高于对照组,差异均有统计学意义(P<0.05);治疗后,观察组谷氨酸(Glu)、γ-氨基丁酸(GABA)、多巴胺(DA)、乙酰胆碱(Ach)等神经递质功率亦显著高于对照组,差异均有统计学意义(P<0.05);治疗后,观察组治疗有效率(95.83%)高于对照组(79.17%),差异具有统计学意义(P<0.05);治疗后,两组不良反应情况差异无统计学意义(P>0.05)。结论联合舒肝解郁胶囊与艾司西酞普兰治疗脑梗死后抑郁症患者疗效较好,能有效提升血浆5-HT水平及神经递质功率,降低抑郁焦虑程度,促进神经功能损伤快速康复,具有较高用药安全性。

Objective To explore the efficacy of combining Shugan Jieyu Capsules with escitalopram in the treatment of post-stroke depression and its effects on 5-hydroxytryptamine(5-HT)and neurotransmitter power.Methods From June 2020 to June 2023,patients with post-stroke depression admitted to the People’s Hospital of Jiyuan were classified according to traditional Chinese medicine syndrome differentiation.A total of 96 patients with liver depression and spleen deficiency were selected as research subjects and randomly divided into two groups,with 48 cases in each group.All 96 patients received routine treatment.The control group was treated with escitalopram,while the observation group was treated with Shugan Jieyu Capsules combined with escitalopram.The Hamilton Depression Scale(HAMD)scores,Hamilton Anxiety Scale(HAMA)scores,NIH Stroke Scale(NIHSS)scores,5-HT levels,neurotransmitter power,efficacy,and adverse reactions were compared between the two groups before and after treatment.Results After treatment,the HAMD,HAMA,and NIHSS scores in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the 5-HT concentrations in both groups increased,and the 5-HT concentration in the observation group was significantly higher than that in the control group,with the differences being statistically significant(P<0.05).After treatment,the neurotransmitter power of glutamate(Glu),γ-aminobutyric acid(GABA),dopamine(DA),and acetylcholine(Ach)in the observation group was significantly higher than that in the control group,with statistically significant differences(P<0.05).The effective treatment rate in the observation group(95.83%)was higher than that in the control group(79.17%),with statistically significant differences(P<0.05).There was no statistically significant difference in adverse reactions between the two groups after treatment(P>0.05).Conclusion The combination of Shugan Jieyu Capsules and escitalopram in the treatment of post-stroke depression has good efficacy,can effectively increase plasma 5-HT levels and neurotransmitter power,reduce depression and anxiety,promote rapid recovery of neurological function,and has high medication safety.