柴胡疏肝散配合针刺治疗肝气郁结型卒中后抑郁临床观察

Clinical Observation on the Therapeutic Effect of Chaihu Shugan Powder(柴胡疏肝散)Combined with Acupuncture on Poststroke Depression of Liver Qi Stagnation Type

目的观察柴胡疏肝散配合针刺治疗肝气郁结型卒中后抑郁(PSD)患者40例的临床疗效。方法将符合纳入标准的80例脑卒中后抑郁患者随机分为研究组和对照组,各40例,两组PSD患者均接受基础卒中治疗和其他对症治疗。对照组口服盐酸帕罗西汀片,研究组在对照组的基础上联合柴胡疏肝散加针刺治疗,共治疗6周。比较并分析两组患者治疗前后各时间段的总有效率,24项汉密尔顿抑郁量表(HAMD-24)、神经功能缺损评分量表(NIHSS)、中医证候量表评分改善情况。并且比较分析两组PSD患者治疗前后的血清IL-6、BNDF、Hcy及5-HT、NE、DA的变化情况。结果两组患者治疗6周后,HAMD-24、NIHSS、中医证候评分相比较于治疗前均有统计学意义(P<0.05);治疗6周后,研究组中患者血清的IL-6、Hcy减低水平及BNDF的升高水平均优于对照组,差异具有统计学意义(P<0.05)。在治疗6周后,研究组患者中的血清5-HT、NE、DA的提高水平均表现为优于对照组,差异具有统计学意义(P<0.05)。结论柴胡疏肝散配合针刺干预治疗肝气郁结型PSD患者,能够有效改善PSD患者相关的临床症状,提高PSD治疗的总有效率,改善患者的抑郁程度和中医证候表现,减轻中风的严重程度,降低患者血清中的IL-6、Hcy水平,升高患者血清中的BNDF、5-HT、NE、DA的水平。

Objective To observe the clinical efficacy of Chaihu Shugan Powder(柴胡疏肝散)combined with acupuncture in treating 40 cases of post stroke depression(PSD)of liver Qi stagnation type.Methods 80 patients with post stroke depression who met the inclusion criteria were randomly divided into the study group and the control group,with 40 patients in each group.Both groups of PSD patients received basic stroke treatment and other symptomatic treatment.The control group was orally treated with paroxetine hydrochloride,while the study group was treated with Chaihu Shugan Powder and acupuncture on the basis of the control group.A total of 6 weeks of treatment.Compare and analyze the total effective rate of the two groups of patients at each time period before and after treatment,as well as the scores of the 24 Hamilton Depression Scale(HAMD-24),Neurological Deficiency Scale(NIHSS),and TCM Syndrome Scale.And compare and analyze the changes of serum IL-6,BNDF,Hcy,5-HT,NE,DA in the two groups of PSD patients before and after treatment.Results After 6 weeks of treatment,the scores of HAMD-24,NIHSS,and TCM syndromes in both groups were statistically significant compared to those before treatment(P<0.05);After 6 weeks of treatment,the levels of IL-6,Hcy decrease,and BNDF increase in the serum of patients in the study group were better than those in the control group,and the differences were statistically significant(P<0.05).After 6 weeks of treatment,the serum levels of 5-HT,NE,and DA in the study group were significantly higher than those in the control group(P<0.05).Conclusion Chaihu Shugan Powder combined with acupuncture intervention can effectively improve the clinical symptoms related to PSD patients with stagnation of liver Qi,improve the overall effective rate of PSD treatment,improve the degree of depression and TCM symptoms,alleviate the severity of stroke,reduce the levels of IL-6,Hcy in patients'serum,and increase the levels of BNDF,5-HT,NE,and DA in patients'serum.