加味甘麦大枣汤联合黛力新治疗脑卒中后抑郁症(1)
摘要 目的：探讨加味甘麦大枣汤联合黛力新对脑卒中后抑郁(PSD)患者抑郁状态、神经递质和睡眠质量的影响。方法：选取2016年8月至2019年8月西安市精神卫生中心收治的PSD患者85例作为研究对象，按照随机数字表法随机分为对照组(n=42)和观察组(n=43)。对照组在常规治疗的此基础上给予黛力新治疗，观察组在常规治疗的基础上给予加味甘麦大枣汤联合黛力新治疗。比较2组的临床疗效、治疗前后的汉密尔顿抑郁量表(HAMD)评分、神经功能缺损量表(NFDS)评分及匹斯堡睡眠指数(PSQI)评分。检测2组治疗前后的血清5-羟色胺(5-HT)、去甲肾上腺素(NE)及多巴胺(DA)水平。记录2组患者治疗过程中不良反应的发生情况。结果：观察组的总有效率为95.35%(41/43)，高于对照组的80.95%(34/42)(χ2=4.242，P=0.039)。治疗后，2组HAMD评分、NFDS评分及PSQI评分均较治疗前低(P<0.05)，且观察组上述评分较对照组低(P<0.05);2组血清5-HT、NE及DA水平均高于治疗前，且观察组上述指标较对照组高(P<0.05)。治疗过程中2組均无严重的不良反应。结论：加味甘麦大枣汤联合黛力新治疗PSD的临床疗效显著，有助于PSD患者睡眠质量的改善，抑郁状态和神经功能缺损的减轻，且安全性较好。
关键词 脑卒中;抑郁;加味甘麦大枣汤;黛力新;抑郁状态;神经递质;睡眠质量
Abstract Objective：To explore effect of Jiawei Ganmai Dazao Decoction combined with deanxit on depressive states，neurotransmitters and sleep quality of patients with post-stroke depression(PSD).Methods：A total of 85 patients with PSD who were admitted to Xi′an Mental Health Center from August 2016 to August 2019 were selected as the research objects.According to the random number table，they were divided into a control group(n=42)and an observation group(n=43).The control group were treated with deanxit on the basis of the conventional treatment，while the observation group were treated with modified Ganmai Dazao Decoction combined with deanxit on the basis of the conventional treatment.The clinical efficacy，Hamilton depression scale(HAMD)score，neurological impairment scale(NFDS)score and Pittsburgh sleep index(PSQI)score before and after treatment were compared between the 2 groups.Serum levels of serotonin(5-HT)，norepinephrine(NE)，and dopamine(DA)were measured in both groups before and after treatment.The adverse reactions of the 2 groups during the treatment were recorded.Results：Total effective rate of treatment group was 95.35%(41/43)，which was significantly higher than 80.95%(34/42)of the control group(χ2=4.242，P=0.039).After treatment，HAMD score，NFDS score and PSQI score in both groups were lower than before treatment(P<0.05).Those in the treatment group were lower than those in the control group(P<0.05).Serum levels of 5-HT，NE and DA in both groups were higher than those before treatment.Those in the treatment group were higher than those in the control group(P<0.05).There were no serious adverse reaction of the 2 groups during treatment.Conclusion：Jiawei Ganmai Dazao Decoction combined with deanxit for treatment of PSD has a good efficacy，and it is helpful for the improvement of PSD patients′ sleep quality，the alleviation of depression and neurological impairment，with better safety., http://www.100md.com(李界兴 杨端卓 王波)
关键词 脑卒中;抑郁;加味甘麦大枣汤;黛力新;抑郁状态;神经递质;睡眠质量
Abstract Objective：To explore effect of Jiawei Ganmai Dazao Decoction combined with deanxit on depressive states，neurotransmitters and sleep quality of patients with post-stroke depression(PSD).Methods：A total of 85 patients with PSD who were admitted to Xi′an Mental Health Center from August 2016 to August 2019 were selected as the research objects.According to the random number table，they were divided into a control group(n=42)and an observation group(n=43).The control group were treated with deanxit on the basis of the conventional treatment，while the observation group were treated with modified Ganmai Dazao Decoction combined with deanxit on the basis of the conventional treatment.The clinical efficacy，Hamilton depression scale(HAMD)score，neurological impairment scale(NFDS)score and Pittsburgh sleep index(PSQI)score before and after treatment were compared between the 2 groups.Serum levels of serotonin(5-HT)，norepinephrine(NE)，and dopamine(DA)were measured in both groups before and after treatment.The adverse reactions of the 2 groups during the treatment were recorded.Results：Total effective rate of treatment group was 95.35%(41/43)，which was significantly higher than 80.95%(34/42)of the control group(χ2=4.242，P=0.039).After treatment，HAMD score，NFDS score and PSQI score in both groups were lower than before treatment(P<0.05).Those in the treatment group were lower than those in the control group(P<0.05).Serum levels of 5-HT，NE and DA in both groups were higher than those before treatment.Those in the treatment group were higher than those in the control group(P<0.05).There were no serious adverse reaction of the 2 groups during treatment.Conclusion：Jiawei Ganmai Dazao Decoction combined with deanxit for treatment of PSD has a good efficacy，and it is helpful for the improvement of PSD patients′ sleep quality，the alleviation of depression and neurological impairment，with better safety., http://www.100md.com(李界兴 杨端卓 王波)