中药辨证施治干预脑卒中后抑郁的临床研究(1)
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摘 要：目的：观察中药辨证施治对脑卒中患者的抑郁发生情况。方法：运用临床群体研究的方法，连续登记2008年1月-2010年8月入院、发病48h内的缺血性脑卒中患者。入组病例随机分为对照组和干预组, 对照组根据《中国脑血管病防治指南(试行版)》常规脑卒中治疗4周，干预组在《中国脑血管病防治指南(试行版)》常规脑卒中治疗基础上通过辨证论治加用中药干预4周，4周、12周、24周时分别进行HAMD评分。结果:干预组在4周、12周、24周时脑卒中抑郁率及HAMD评分显著低于对照组，P<0.05。结论:急性期加用中药辨证施治可以减少脑卒中后抑郁的发生。
关键词：中药；辨证施治；脑卒中后抑郁
中图分类号：R743
文献标识码：A
文章编号：1673-7717(2012)04-0808-03
Clinical Research of Syndrome Differentiation and Treatment of TCM to Intervene Post-stroke Depression
ZHANG Ye-qing1, CHEN Mei2
(1.Zhejiang Chinese Medical University，Hangzhou 310053，Zhejiang，China；
2.Zhejiang Chinese Medicine Hospital，Hangzhou 310006，Zhejiang，China)
Abstract:Objective: To observe the incidence of post-stroke depression(PSD)by the syndrome differentiation and treatment of TCM. Method：Consecutive acute ischemic stroke patients in the ward of Neurology Department，Zhejiang Chinese Medicine Hospital were analyzed using group research method from January 2008 to August 2010. Patiets were randomly departed into two groups in this study，treatment group and control group.The latter got 4 weeks` conventional therapy according to China Cerebrovascular Disease Prevention and Treatment Guidelines. Unlike control gourp，treatment gourp got extra synchronous therapy of TCM according to patients` individual symptoms. Each patient was tested with Hamilton Depression Scale(HAMD)in 4 weeks'，12weeks' and 24weeks' time respectively. Results：The incidence of PSD of the treatment group as well as the scores of HAMD，was significantly lower than those of the control group by 4 weeks'，12 weeks' and 24weeks' follows-up surveys，P<0.05. Conclusions：The syndrome differentiation and treatment of TCM for acut ischemic stroke lowers the incidence of PSD.
Key words:TCM；syndrome differentiation and treatment；post-stroke depression
脑卒中后抑郁(PSD)是指脑卒中发生后，患者除神经功能缺损外，还出现以情绪低落、消极悲观、兴趣减退等症状的病症。PSD延缓神经功能的恢复,严重影响患者的日常生活质量,甚至增加脑卒中的病死率,不仅给患者带来躯体上和精神上的痛苦,而且增加了家庭和社会负担。据报道在所有卒中生存者的跟踪调查中发现约有33%的人有抑郁症状[1]。本研究就我院入院诊断为急性缺血性脑卒中患者进行临床研究,现分析如下。
1对象与方法
1.1临床资料
1.1.1病例来源 本研究数据来源于浙江省中医药科研资助项目(2008GA009)、浙江省科技计划项目(2009C33162),在省科技基金资助下进行了深入研究。课题组从2008年初开展了脑卒中中医四诊信息、神经功能缺损程度等临床信息采集。为保证临床信息采集的真实性和准确性,参加本次临床信息采集的人员均经过统一培训并通过考核 ......
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