柴胡疏肝散加味联合草酸艾司西酞普兰治疗卒中后抑郁的疗效

Therapeutic Effect of Modified Chaihu Shugan Decoction combined with Escitalopram Oxalate on Post-stroke Depression

目的探讨柴胡疏肝散加味联合草酸艾司西酞普兰治疗卒中后抑郁(PSD)的疗效。方法选取2021年12月至2023年6月南京中医药大学附属苏州市中医医院收治的126例PSD患者作为研究对象,采用随机数字表法分为试验组和对照组,各63例,试验组脱落1例,共62例,对照组脱落3例,共60例。对照组予以草酸艾司西酞普兰治疗,试验组在对照组基础上加用柴胡疏肝散加味治疗。比较两组临床疗效,治疗前后汉密尔顿抑郁量表-17(HAMD-17)评分、日常生活活动能力量表(ADL)评分、血清5-羟色胺(5-HT)、去甲肾上腺素(NE)、多巴胺(DA)水平,治疗过程中不良反应发生情况。结果试验组治疗有效率高于对照组(P<0.05);治疗后两组HAMD-17评分降低(P<0.05),且试验组低于对照组(P<0.05);治疗后两组ADL评分升高(P<0.05),且试验组高于对照组(P<0.05);治疗后两组5-HT、NE、DA升高(P<0.05),且试验组高于对照组(P<0.05);试验组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论柴胡疏肝散加味联合草酸艾司西酞普兰治疗PSD可提高临床疗效,改善抑郁情绪和生命质量,增加血清5-HT、NE、DA等神经递质水平,用药安全可靠。

Objective To explore the curative effect of Chaihu Shugan decoction combined with Escitalopram oxalate on post-stroke depression(PSD).Methods A total of 126 PSD patients admitted to Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from December 2021 to June 2023 were selected as the study objects,and were divided into test group and control group by random number table method,with 63 cases in each group,with 1 case shedding,a total of 62 cases,and 3 cases shedding,a total of 60 cases.The control group was treated with escitalopram oxalate,and the experimental group was treated with Chaihu Shugan decoction on the basis of control group.The clinical efficacy,the score of Hamilton Depression Scale-17(HAMD-17),Activity of Daily Living Scale(ADL),serum levels of 5-hydroxytryptamine(5-HT),norepinephrine(NE)and dopamine(DA)before and after treatment,and the occurrence of adverse reactions during treatment of the two groups were compared.Results The effective rate of experimental group was higher than that of control group(P<0.05).After treatment,the HAMD-17 score of both groups was decreased(P<0.05),and the test group was lower than the control group(P<0.05).After treatment,the ADL score of the two groups was increased(P<0.05),and the test group was higher than the control group(P<0.05).After treatment,5-HT,NE and DA were increased in both groups(P<0.05),and those in experimental group were higher than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the experimental group and the control group(P>0.05).Conclusion Chaihu Shugan decoction combined with Escitalopram oxalate in the treatment of PSD can improve clinical efficacy,improve depression and quality of life,and increase the levels of serum 5-HT,NE,DA and other neurotransmitters.The drug is safe and reliable.