Study on the Efficacy of Shugan Jieyu Capsules Combined with Trazodone in Patients with Post-Stroke Depression and Insomnia

Objective:To analyze the effectiveness of applying ShuGan JieYu Capsules(SGJYC)combined with trazodone in patients with post-stroke depression(PSD)with insomnia.Methods:60 cases of PSD with insomnia patients admitted to the hospital from May 2022 to May 2023 were selected and randomly divided into a reference group(trazodone)and a research group(SGJYC combined with trazodone)of 30 cases each.Statistics were analyzed using the Hamilton Depression Rating Scale(HAM-D),Pittsburgh Sleep Quality Index(PSQI),and Activities of Daily Living(ADL)scale before treatment and 4,8,and 12 weeks after treatment.Results:Before treatment,The results of HAM-D,PSQI,and ADL scale studies in the two groups before treatment were not statistically significant(P>0.05);4,8,and 12 weeks after treatment,the results of HAM-D and PSQI studies in the research group were lower than that of the reference group,and the results of ADL scale studies were higher than that of the reference group.There was a significant difference between the groups(P<0.05).The total adverse reaction rate of the research group was lower than that of the reference group,and there was a significant difference between the groups(P<0.05).Conclusion:The combination of SGJYC and trazodone reduced depression in post-stroke patients,corrected insomnia,improved sleep quality,was safe,and had a low rate of adverse reactions.

Clinical Study of Acupuncture Combined with Emotional Intervention in Patients with Post-Stroke Depression

Objective:To investigate the clinical efficacy of acupuncture combined with emotional intervention in patients with post-stroke depression(PSD).Methods:A total of 100 patients with PSD who met the inclusion criteria were randomly divided into an experimental group(50 cases)and a control group(50 cases)using the random number table method,and the enrollment was in order of admission time.The control group used conventional treatment of oral antidepressant Deanxit tablets(0.5 mg flupenthixol+10 mg melitracen)with the dose appropriately adjusted according to the patient’s medication effect,and modern rehabilitation treatment given selectively according to the patient’s condition.The experimental group had similar treatment as the control group with the addition of traditional Chinese medicine(TCM)acupuncture combined with emotional intervention.The application effects of both groups before and after treatment were verified using the Hamilton Depression Rating Scale(Ham-D),National Institutes of Health Stroke Scale(NIHSS),and Activities of Daily Living(ADL),serotonin levels were measured,and statistical analyses were carried out.Results:The total effective rate of patients in the experimental group was significantly higher than that in the control group,and the Ham-D score,NIHSS score,ADL score,and serotonin level after treatment were significantly higher than those in the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion:For patients with PSD,adding TCM acupuncture with emotional intervention on top of conventional treatment significantly improve the clinical efficacy and better improve the daily life ability of patients.

Clinical Observation of Huatanjieyu Granule in the Treatment of Post-stroke Depression

[Objectives]To observe the clinical effect of Huatanjieyu granule on patients with post-stroke depression.[Methods]Total 76 patients with confirmed post-stroke depression were randomly divided into two groups(treatment group and control group)according to the double-blind principle.The treatment group(38 cases)was treated with Huatanjieyu granule combined with escitalopram,and the control group(38 cases)was treated with escitalopram alone.The course of treatment was 6 weeks.Through clinical efficacy,Hamilton Depression Scale(HAMD)and Treatment Emergent Symptom Scale(TESS)scores were compared,and blood,liver function,renal function and electrocardiogram were examined.[Results]The scores of HAMD and TESS in patients with post-stroke depression were significantly decreased by Huatanjieyu granule,and there were no obvious side effects.The total effective rate was 92.1%in the treatment group and 76.3%in the control group.There was significant difference between the two groups(P<0.01).[Conclusions]Huatanjieyu granule was effective in the treatment of post-stroke depression with little side effects and was easy to be accepted by patients.

Research Progress in the Pathogenesis of Post-stroke Depression

Post-stroke depression is an affective disorder that occurs after stroke.Its pathogenesis has not yet been fully understood,and it mainly involves neurobiology,neuroanatomy,and psychology.This paper provides an overview on the neurobiological mechanism of post-stroke depression to further understand post-stroke depression and to provide references for further research.

Effect of different therapies of Chinese medicine on the expressions of c-Fos and c-Jun proteins in hippocampus of rats with post-stroke depression

BACKGROUND: c-fos and c-jun, the important immediate early genes (IEG), are regarded as the markers for the location and function of neuronal activity, as well as the third signal messengers, they couple the stress stimulation and the gene expression in neuron, and hippocampus is involved in the process of signal transmission after stress stimulation induced depression. OBJECTIVE: To observe the therapeutic effects of Bushen Yiqi (tonifying kidney to benefit qi), Huoxue Huayu (promoting blood circulation to dissipate blood stasis) and Ditan Kaiqiao (eliminating phlegm for resuscitation) on the expressions of c-Fos and c-Jun proteins in hippocampus and spontaneous behaviors of rats with post-stroke depression (PSD), and compare the results with those of fluoxetine, which is known to have definite effect on depression. DESIGN: A randomized controlled trial. SETTING: Zhejiang College of Traditional Chinese Medicine. MATERIALS: The trial was completed in Zhejiang College of Traditional Chinese Medicine from January to July in 2003. Fifty-six healthy adult Wistar male rats of clean grade, weighing (250±50) g, were randomly divided into 7 groups with 8 rats in each group: control group, model group, forced swimming group, Bushen Yiqi group; Huoxue Huayu, Ditan Kaiqiao group and fluoxetine group. The Bushen Yiqi Tang contained Renshen, Huangqi, Heshouwu, Gouqi, Shudi, etc., crude drugs 1 800 g/L. The Huoxue Huayu Tang contained Danshen, Chuanxiong, Chishao, Yujin, etc., crude drugs 3 600 g/L. The Ditan Kaiqiao Tang contained Banxia, Danxing, Changpu, Yuanzhi, etc., crude drug 1 000 g/L. METHODS: ① Except the control group and forced swimming group, rats in the other groups were made into PSD models by deligating the bilateral common carotid arteries permanently. ② Rats in the control group, model group and forced swimming group were intragastrically perfused by saline (3 mL for each time); those in the Bushen Yiqi group, Huoxue Huayu, Ditan Kaiqiao group and fluoxetine group were intragastrically perfused with Bushen Yiqi Tang (18 g/kg), Huoxue Huayu Tang (9 g/kg), Ditan Kaiqiao Tang (9 g/kg) and fluoxetine (2.5 mg/kg) respectively, once a day. ③ At 55 days after model establishment, rats in the forced swimming group were managed according to the Porsolt’s method. They were placed in water for 15 minutes, and then taken out and dried, no moving-time within 5 minutes was recorded at drying and 24 hours after drying. ④ Measurement of spontaneous behaviors: Except the forced swimming group, the spontaneous behaviors and activities (including horizontal and vertical movements) of rats were observed with the Open-Field method at 28, 42 and 56 days after administration in the other groups. ⑤ The expressions of c-Fos and c-Jun proteins in hippocampus were determined with the immunohistochemical method, the relative sectional area ratio and average objective gray value of c-Fos and c-Jun positive cells in hippocampus were measured with the computerized image analytical system. MAIN OUTCOME MEASURES: The spontaneous behaviors of rats, the relative sectional area ratio and average objective gray value of c-Fos and c-Jun positive cells in hippocampus were observed. RESULTS: Of the 56 rats, 1 died in the forced swimming group, and finally 55 rats were involved in the analysis of results. ① Results of spontaneous activities: At 28 days, the times of crossing movements were obviously fewer in the model group and fluoxetine group [(69.00±37.01), (98.11±36.68) times/3 minutes] than in the control group [(128.44±16.85) times/3 minutes, P < 0.01, 0.05], but those in the Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group had no obvious differences as compared with those in the control group (P > 0.05). At 42 and 56 days, the times of crossing movements were obviously more in the Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group [(106.44±31.24), (117.20±23.95), (134.80±28.18), (136.36±40.95) times/3 minutes; (117.33±35.91), (129.60±23.78), (131.90±26.81), (136.09±28.34) times/3 minutes] than in the model group [(64.00±17.51), (72.86±20.68) times/3 minutes, P < 0.01]. The times of rearing movements had no obvious differences among the groups for the three times (P > 0.05). ② The no moving-time within 5 minutes 24 hours after drying was obviously longer than that at drying in the forced swimming group. ③ The average objective gray values of c-Fos positive cells were not obviously different in the Bushen Yiqi group and Ditan Kaiqiao group from the control group (P > 0.05), but lower in the model group than in the control group (69.84±9.82, 75.78±5.89, P < 0.01), and higher in the forced swimming group than in the control group (85.97±10.99, P < 0.01); all higher in the fluoxetine group, Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group than in the model group (81.27±10.73, 74.04±8.34, 83.29±9.89, 70.14±4.92, P < 0.05-0.01). The average objective gray values of c-Jun positive cells were obviously lower in the Bushen Yiqi group than in the control group (68.11±6.89, 79.58±5.86, P < 0.01), but all higher in the other groups than in the control group (84.68±7.15, 81.34 ±8.36, 97.51±10.55, 85.68±9.25, 86.19±10.98, P < 0.05-0.01); Those were obviously higher in the fluoxetine group, Huoxue Quyu group and Ditan Kaiqiao group than in the model group (P < 0.05-0.01), lower in the Bushen Yiqi group than in the model group (P < 0.05), all obviously lower in the Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group than in the fluoxetine group (P < 0.01). The relative sectional area ratios of c-Fos and c-Jun positive cells had no obvious differences among the groups (P > 0.05). CONCLUSION: The methods of Bushen Yiqi, Huoxue Quyu and Ditan Kaiqiao can effectively treat PSD in rats, and the results were equivalent with those of fluoxetine, the actions of the above-mentioned drugs may correlated with their regulation to c-Fos and c-Jun expressions in hippocampus. PSD animal models can be successfully established by both permanent deligation of bilateral common carotid arteries and forced swimming, and the models induced by the former has similar basic cerebrovascular lesions as human stroke in clinic.

Research progress on pharmacological effect of Salvianolic acid for injection in post-stroke depression

Post-stroke depression (PSD) is one of the most common affective disorders after acute cerebrovascular injury. It significantly increases the mortality, disability rate and recurrence rate of stroke, which places a heavy burden on families and society. The etiology of PSD is not yet clear, involving a series of complex mechanisms. Inflammatory response, apoptosis, neurotrophic factors, neurotransmitters and many others may play important roles, and there is no effective treatment. Salvianolic acid for injection (SAFI) has the functions of anti-inflammatory, anti-oxidative stress, anti-apoptotic and can improve depressive behavior. It is expected to become a new antidepressant for the treatment of PSD.

Systematic review and meta-analysis on efficacy of traditional Chinese medicine in treatment of inflammatory factors in patients with post-stroke depression

Objective:To systematically evaluate the effect of traditional Chinese medicine on inflammatory factors in patients with post-stroke depression(PSD)and the efficacy of traditional Chinese medicine on PSD.Methods:Chinese databases(Sinomed,CNKI,VIP,Wanfang),PubMed,Cochrane Library,and Web of Science were searched.Randomized controlled trials of patients with PSD treated with traditional Chinese medicine were included.Quality evaluation was performed and Meta-analysis was performed using RevMan 5.4 software.Results:The results show that TCM therapy is superior to western medicine in reducing the level of TNF-α[MD=-4.13,95%CI(-4.75,-3.51),P<0.00001],IL-6[MD=-3.39,95%CI(-3.90,-2.88),P<0.00001]and IL-8[MD=-2.12,95%CI(-2.49,-1.75),P<0.00001]in venous blood of PSD patients,and is superior to western medicine in reducing the score of HAMD[MD=-4.22,95%CI(-5.37,-3.07),P<0.00001]and NIHSS[MD=-2.33,95%CI(-3.43,-1.23),P<0.0001].The combination of Chinese medicine and western medicine is superior to western medicine in reducing the level of TNF-α[MD=-10.61,95%CI(-15.30,-5.91),P<0.00001]、IL-1[MD=-3.75,95%CI(-4.51,-2.99),P<0.00001]、IL-6[MD=-3.83,95%CI(-4.49,-3.16),P<0.0001]、IL-8[MD=-9.41,95%CI(-14.89,-3.92),P<0.00001]and Hcy[MD=-3.81,95%CI(-4.62,-2.99),P<0.00001]in venous blood of patients with PSD,and is superior to western medicine in reducing the score of HAMD[MD=-3.06,95%CI(-3.39,-2.73),P<0.00001]、NIHSS[MD=-4.47,95%CI(-7.55,-1.39),P=0.004]and HAMA[MD=-2.83,95%CI(-3.47,-2.19),P<0.00001]and improving BI index.Three studies do not mention adverse reactions,and 37 cases in the remaining three studies show rash,tremor,dizziness and other adverse reactions.The incidence of adverse reactions in the experimental group was lower than that in the control group,and there were no serious adverse reactions.Conclusion:The results suggest that traditional Chinese medicine can reduce the level of some inflammatory factors in patients with PSD to a certain extent,and its efficacy is better than that of western medicine alone.Nevertheless,this study has some limitations,and with the increase of related trials in the future,the conclusions of the study need to be further discussed by adding more high-quality RCT studies.

Meta-analysis of the relationship between post-stroke depression and the risk of mortality

Objective:To evaluate the relationship between post-stroke depression(PSD)and the risk of mortality in post stroke patients.Methods:Cohort studies related to PSD and risk of mortality were collected by searching PubMed,Cochrane Library,EMBASE,WanFang Data,CNKI and VIP databases.The retrieval time limit was from the establishment of the database to January 2020.The meta-analysis was carried out by Using Stata software after two researchers independently selected literature,extracted data and evaluated the bias risk.Results:A total of 243826 participants were included in 12 studies.The combined results showed that PSD increased all-cause mortality in stroke patients[HR=1.51,95%CI(1.16,1.85),P<0.001].Subgroup analysis also showed that PSD significantly increased all-cause mortality in stroke patients during brief-term follow-up:[HR=1.45,95%CI(0.96,1.93),P<0.001]and long-term follow-up:[HR=1.51,95%CI(1.23,1.79),P<0.001].Conclusion:PSD can significantly increase the risk of mortality in post-stroke patients.Considering the limitation of potential heterogeneity,more high-quality literature studies are needed to verify.

Discussion on the law of acupoint selection by acupuncture in the treatment of post-stroke depression based on the data mining technique

Objective:To analyze the law of acupoint selection in treatment of depression after stroke by using data mining technique,providing reference for clinical treatment.Methods:Through the retrieval of CNKI,wanfang data resource system and Vip Database,relevant literature on acupuncture treatment of this disease in China from the inception of the database to 2019 were collected.Thus the database of acupoint prescriptions was established.SPSS20.0 and SPSS Modeler 18.0 software were used for statistical analysis to explore the law of acupoint selection.Results:A total of 92 articles were selected,92 acupuncture prescriptions and 88 acupoints with a total frequency of 715 times.The frequency of acupoints of Du channel ranked first.The frequency of acupoints in the head and neck and lower limbs were successively 40.42%(289/715)and 20.46%(172/715).Specific acupoints accounted for 81.82%of the acupoints used,among which confluent acupoints ranked first.The correlation analysis results showed that the highest support of acupoint combination was Baihui(GV20)and Shenting(GV24).Conclusion:The acupoint selection in the treatment of PSD gives priority to the Du channel,following the principle of local acupoint selection,local and remote acupoint selection with the precondition of regulation the mind.Attach importance to the use of specific acupoints,especially the confluent points.

Progress of Traditional Chinese Medicine in the Treatment of Post-stroke Depression

The patients with post-stroke depression often form a negative evaluation of themselves,and even have the idea of suicide in serious cases.Therefore,post-stroke depression has become one of the most common complications of mental illness after stroke,which seriously hinders the normal rehabilitation of the central nervous system,thus increasing the disability rate,early recurrence rate and mortality rate of patients.Therefore,the active treatment of post-stroke depression is very necessary.Western medicine uses antidepressant drugs for this kind of patients,but because the side effects of antidepressants are relatively large,the compliance of patients is not good,it is not easy to see the effect,while traditional Chinese medicine(TCM)has many ways to deal with post-stroke depression with obvious advantages,the side effects are relatively small,and there is more compliance in patients.This paper focuses on several TCM treatment methods,hoping to provide a reference for the treatment of post-stroke depression.

CLINICAL STUDY ON ACUPUNCTURE IN THE TREATMENT OF POST-STROKE DEPRESSION WITH THE METHOD OF ACTIVATING THE DU MERIDIAN AND CLEARING THE MIND

Objective: To observe the therapeutic effect of acupuncture in the treatment of post-stroke depression (PSD) with the method of activating the Du Meridian and clearing the mind. Methods: Two hundred and thirty one cases of PSD were randomly divided into two groups, acupuncture and control groups. In acupuncture group, Baihui (百会 GV 20), Dazhui (大椎 GV 14), Neiguan (内关 PC 6), Taichong (太冲 LR 3) and Shenmen (神门 HT 7) were selected as the main points to invigorate flow of qi in the Du Meridian and clear the mind. Patients in the control group received Fluoxetine orally, 20 mg once per-day. In addition, the same routine treatments were given to both groups, strengthened with rehabilitation exercises as early as possible; 8 weeks constituted one therapeutic course. HAMD and severity of neuro-functional defect of each case were evaluated before and 8-week after the treatment. Results: The total effective rate of acupuncture group was 92.37%, the control group, 72.88%. According to χ2 test, the difference between the two groups was remarkably significant (P<0.05). Conclusion: Acupuncture therapy of activating the Du Meridian and clearing the mind in the treatment of PSD was safe and effective.

Role of Transcranial Direct Current Stimulation in the Management of Post-Stroke Depression

Study Objectives: Stroke is a major neurological disease significantly threatening the human health and life with a high morbidity, disability, and mortality. Post-stroke depression (PSD) is one of the common complications of stroke. PSD has been a major factor hindering the recovery of neurological functions and daily activities in stroke patients and is closely related to the social avoidance and increased mortality of stroke patients. Although antidepressant drug treatment has improved during the last decades, symptoms in about 20% of the patients are not in remission two years after initiation of pharmacological intervention. Nowadays, non-invasive brain stimulation;techniques;transcranial direct current stimulation (tCDS) has gained an important interest in the treatment of many neuropsychiatric disorders which might be of some help in treatment of PSD. The goal of the current study is to evaluate the beneficial short term role of tDCS on post-stroke depression. Study Design: This was a randomized double blind placebo-controlled clinical trial included forty hemiparetic patients with post-stroke depression from outpatient clinic of Faculty of Physical Therapy, Cairo University, in the period between June 2018 to June 2019. All patients diagnosed as having a PSD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Depression was evaluated by Hamilton Depression Rating Scale (HAM-D) pre and post treatment and quality of life was evaluated by the Stroke Specific Quality Of Life scale (SS-QOL). Patients were assigned randomly into two groups: the study group A and the control group B. Both groups received antidepressant medication in addition to physical therapy program. Group A received tCDS for 30 minutes, three times per week for one month, while the group B received sham transcranial direct current stimulation. Results: Active tDCS was significantly superior to sham with significant improvement in depression and Stroke Specific Quality Of Life in treated group in comparison to group B, p = 0.000. Conclusion: tDCS was effective for post- stroke depression and might be a favorable option for treating post-stroke patients.

Melatoninergic Antidepressant in Post-Stroke Depression Therapy

This paper presents the results of the effects of Melitor (25 mg during two months) on the psychic-emotional state, cerebral hemodynamic and bioelectrical activity of the brain in 30 patients (average age 66.2 ± 3.2 years) with ischemic post-stroke depression. It has been found that this drug possesses a multimodal action which is characterized by the decrease of the level of depression, widening of the range of social-environmental activity, improvement of the cerebral blood circulation and harmonization of the brain electrogenesis. In the patients with right versus left hemisphere stroke, the effect of Melitor on the functional state of the brain was more pronounced. Based on the results obtained in our study, we can recommend Melitor to use it in complex scheme of rehabilitation care of patients of the given nosological category.

Sociodemographic profile and social support for post-stroke depression in Kinshasa: A rehabilitation based cross-sectional study

The World Health Organization has highlighted the emergence of non-communicable chronic diseases, including stroke, in developing countries. As a cause of death, stroke ranks first in Africa. Stroke is the foremost cause of neuropsychiatric disease, including post-stroke depression (PSD) which is a very common disease. Surveys of this condition in Congolese pa tients are virtually non-existent. The objectives of this study were to assess the prevalence of PSD in Congolese patients and identify associated sociodemographic factors. Age, sex, address, province of origin, social and professional status, education, religion and consumption habits were chosen as indicators or parameters of interest to be examined in this study. The results of descriptive analyses are presented as frequencies for categorical variables and as mean ± standard deviation for quantitative variables. The association between different variables was assessed using tables of comparisons of proportions and the Chi-square test. Logistic regression was performed to predict the occurrence of PSD. There were more male than female patients. The mean age was 54.67 ± 12.51 years. Nearly 3 fourths of the patients were aged less than 65. The family was the primary source of social support. The majority was satisfied by the social support received from the family. Just over half the study patients (53.6%) had mild to severe depression as assessed by the PHQ9. Univariate analysis and logistic regression indicated a statistically significant association between low educational level and the occurrence of PSD. However, there was no relationship between age, sex or drinking habits and the onset of PSD. The majority of the subjects were satisfied by the social support from their families. Depression was common after stroke with the occurrence of 53.6%. These results highlight the need to investigate, diagnose and treat PSD, which is a risk factor for morbidity and mortality after stroke.

Effects of IL-6 and Cortisol Fluctuations in Post-stroke Depression

Depression is an important post-stroke sequela with negative impact on mortality, functional outcome and quality of life. Changes in cytokines have been hypothesized to be associated with the etiology of post-stroke depression(PSD). The altere dhypothalamic-pituitary-adrenal(HPA) functioning is associated with the onset of depression. The activity of HPA could induce the fluctuations of cortisol levels. In this study, we prospectively checked interleukin 6(IL-6) and cortisol levels in patients with early ischemic stroke. It was hypothesized that early serum IL-6 and cortisol fluctuations in stroke patients were the predictions of PSD. Totally, 100 participants were selected from stroke inpatients consecutively admitted to the Department of Neurology, Tongji Hospital from July 2014 to December 2015. Fifty health people served as the controls. The serum of all the patients was collected at 8:00 am and 4:00 pm respectively one week after stroke. The serum of controls was collected only at 8:00 am. The levels of IL-6 were analyzed by enzyme-linked immunosorbent assay kit, and those of cortisol were detected by chemiluminescence immunoassay. On the 3rd week after stroke, the patients were enrolled to the PSD group and non-PSD group based on the Diagnostic and Statistical Manual of Mental Disorders(DSM-Ⅳ) and The Hamilton Depression Rating Scale(HAMD-21, score>7). The IL-6 level(13.24±2.89 ng/L) was elevated significantly in PSD groups as compared with that in non-PSD group and control group respectively(P<0.05 for both), but there was no significant difference in the IL-6 level between non-PSD group and control group. The patients in both PSD group and non-PSD group had significantly elevated morning cortisol levels in comparison with those in the control group(P<0.05; for PSD, non-PSD and control: 508.86±119.51, 420.83±70.04 and 340.40±76.30 nmol/L respectively). Moreover, afternoon cortisol levels in PSD group were significantly higher than those in non-PSD group, and the morning baseline cortisol levels in these two groups were similar(P>0.05). It was suggested that PSD generally runs a chronic course and is related to a variety of adverse health outcomes including increased disability, morbidity and mortality. This study will help the screening of potential PSD in the early stage.

Network meta-analysis of long-term efficacy of acupuncture-related therapies and SSRIs in treating post-stroke depression

Objective:To evaluate the effect of existing acupuncture-related therapies on the longterm effects of post-stroke depression(PSD)by using a network meta-analysis with SSRIs as a common reference.Methods:The published randomized controlled clinical trials of acupuncture-related therapies and SSRIs for PSD in PubMed,The Cochrane Library,EMbase,CNKI,CBM,VIP and wan-fang databases were comprehensively searched.The literature retrieval period was from The database establishment to July 31,2020.Cochrane Handbook 5.1.0 was used to assess the risk of bias in included studies.Data analysis is conducted through ADDIS,Review Manager 5.3,and STATA 13.1 software.Results:A total of 3115 patients with PSD were included in 30 RCTs,involving 10 therapeutic methods.Results of network meta-analysis showed that:in terms of total effective rate,body acupuncture+SSRIs was superior to body acupuncture[OR=2.85,95%CI(1.51,5.90)]and SSRIs[OR=5.37,95%CI(3.03,10.33)].In terms of HAMD score,body acupuncture+SSRIs was superior to body acupuncture[MD=1.69,95%CI(0.33,3.06)]and SSRIs[MD=3.87,95%CI(2.68,5.08)].The above ranking predicted that moxibustion+SSRIs was the best.In terms of NIHSS score,body acupuncture[MD=2.15,95%CI(1.10,3.26)]and body acupuncture+SSRIs[MD=1.77,95%CI(0.19,3.37)]were better than SSRIs.Conclusion:Moxibustion combined with SSRIs is the best for the long-term efficacy of acupuncture and moxibustion on PSD.Body acupuncture combined with SSRIs is better than SSRIs alone.The other therapies have their own advantages and disadvantages.Based on the defects of existing studies,this conclusion still needs to be verified by more high-quality RCTs.

Research progress of post-stroke depression model

Post-stroke depression(PSD)is one of the complications after stroke,with an incidence of about 31%.There are different opinions on the pathogenesis of PSD,but it is still unclear and needs further study.At present,in addition to clinical research,the establishment and research of PSD animal model is an important part of the basic research of PSD.Therefore,it is very important to establish an effective animal model.In this paper,combined with the current situation at home and abroad,the relevant models are summarized and summarized.

Effect of adjuvant acupuncture therapy on serum cytokines and neurotransmitters in patients with post-stroke depression

Objective:To study the effect of adjuvant acupuncture therapy on serum cytokines and neurotransmitters in patients with post-stroke depression.Methods: Patients with poststroke depression who were treated in Traditional Chinese Medicine Hospital of Yuyang District Yulin City between May 2014 and February 2017 were selected as the research subjects and divided into two groups by random number table, control group of patients received neurotrophy, rehabilitation exercise, antidepressant drugs and other symptomatic treatment, and the acupuncture group received auxiliary acupuncture treatment on the basis of symptomatic treatment. The serum levels of nerve cytokines, inflammatory cytokines and neurotransmitters were detected before treatment as well as 2 weeks and 4 weeks after treatment.Results: 2 weeks and 4 weeks after treatment, serum BDNF, NGF, IGF-1, FGF-2, NE, DA and 5-HT levels of both groups of patients were higher than those before treatment while HCY, IL-1β, IL-2, sIL-2R, TNF-α levels were lower than those before treatment, and serum BDNF, NGF, IGF-1, FGF-2, NE, DA and 5-HT levels of acupuncture group were higher than those of control group while HCY, IL-1β, IL-2, sIL-2R, TNF-α levels were lower than those of control group.Conclusion: Adjuvant acupuncture therapy for post-stroke depression can increase the secretion of nerve cytokines, reduce the secretion of inflammatory cytokines and regulate the function of monoamine neurotransmitters.

Nerve cell apoptosis in patients with post-stroke depression

Objective:To study the relationship of serum thyroid-stimulating hormone (TSH) levels with neurotransmitters, neurotrophic state and nerve cell apoptosis in patients with post-stroke depression (PSD).Methods: Patients with ischemic stroke who were treated in our hospital between June 2014 and October 2016 were selected, and according to the HAMD-17 score at 14 days after onset, the enrolled patients were divided into into the post-stroke depression group (PSD group) and stroke group (PS group). Serum levels of TSH, neurotransmitters, neurotrophic cytokines and apoptotic molecules were detected.Results: Serum TSH, 5-HT, NE, DA, BDNF and NGF levels of PSD group were significantly lower than those of PS group while Bax, FasL, Fas and Caspase-3 levels were significantly higher than those of PS group;5-HT, NE, DA, BDNF and NGF levels of PSD group of patients with low TSH were significantly lower than those of PSD group of patients with normal TSH while Bax, FasL, Fas and Caspase-3 levels were significantly higher than those of PSD group of patients with normal TSH.Conclusion:The decrease of serum TSH level in patients with PSD can affect neurotransmitters, neurotrophic state and nerve cell apoptosis.

Influence of hyperbaric oxygen combined with psychotropic drugs on serum neurotransmitter and cytokine contents in patients with post-stroke depression

Objective: To investigate the influence of hyperbaric oxygen combined with psychotropic drugs on serum neurotransmitter and cytokine contents in patients with post-stroke depression. Methods: A total of 62 patients with post-stroke depression who were treated in the hospital between January 2015 and February 2017 were divided into routine group (n=31) and hyperbaric oxygen group (n=31) by random number table method. Routine group received antidepressant therapy, hyperbaric oxygen group received hyperbaric oxygen combined with antidepressant therapy, and the therapies lasted for 8 weeks. The differences in the serum contents of monoamine neurotransmitters, inflammatory factors and oxidative stress indexes were compared between the two groups before and after treatment. Results: There was no statistically significant difference in serum levels of monoamine neurotransmitters, inflammatory factors and oxidative stress indexes between the two groups before treatment. After 8 weeks of treatment, serum monoamine neurotransmitters NE, 5-HT and DA contents of hyperbaric oxygen group were higher than those of routine group;serum inflammatory factors IL-1, IL-6, IL-8 and hs-CRP contents were lower than those of routine group;serum oxidative stress indexes LHP and MDA contents were lower than those of routine group whereas CAT and GSH-Px contents were higher than those of routine group. Conclusion:Hyperbaric oxygen combined with psychotropic drug therapy can effectively increase the expression of monoamine neurotransmitters and balance the homeostasis in patients with post-stroke depression.