作者：李宁，吕以静

单位：

266000山东省青岛市，青岛大学附属青岛市海慈医院神经内科

Units：

Department of Neurology, Qingdao Haici Hospital Affiliated to Qingdao University, Qingdao 266000, China

关键词：

抑郁；卒中；豁痰清窍解郁汤；治疗结果

Keywords：

Depression; Stroke; Huotan Qingqiao Jieyu decoction; Treatment outcome

CLC：

R 749.42 R 743

DOI：

10.12114/j.issn.1008-5971.2023.00.206

Funds：

山东省自然科学基金面上项目（ZR202103030420）

摘要：

目的　探讨豁痰清窍解郁汤联合抗抑郁药治疗脑卒中后抑郁（PSD）的效果。方法　选取2019年12月至2020年12月青岛大学附属青岛市海慈医院收治的PSD患者80例，采用随机数字表法将其分为观察组和对照组，每组40例。对照组在常规治疗的基础上接受盐酸氟西汀分散片，观察组在对照组的基础上加用豁痰清窍解郁汤治疗，两组连续治疗2个月。比较两组一般资料、临床疗效和治疗前后中医证候评分、美国国立卫生研究院卒中量表（NIHSS）评分、简易智力状态检查量表（MMSE）评分、IL-1、IL-2、5-羟色胺（5-HT）及不良反应发生率。结果　观察组临床疗效优于对照组（P＜0.05）。两组治疗后情志抑郁、咽喉异物感、胸闷、胁肋刺痛、舌质暗紫或瘀斑、脉细涩评分及中医证候总分分别低于本组治疗前，且观察组治疗后情志抑郁、咽喉异物感、舌质暗紫或瘀斑、脉细涩评分及中医证候总分低于对照组（P＜0.05）。两组治疗后NIHSS评分分别低于本组治疗前、MMSE评分分别高于本组治疗前，且观察组治疗后NIHSS评分低于对照组、MMSE评分高于对照组（P＜0.05）。两组治疗后IL-1、IL-2分别低于本组治疗前，5-HT分别高于本组治疗前，且观察组治疗后IL-1、IL-2低于对照组，5-HT高于对照组（P＜0.05）。两组不良反应发生率比较，差异无统计学意义（P＞0.05）。结论　豁痰清窍解郁汤联合抗抑郁药能提高PSD患者临床疗效，改善患者中医证候、神经功能及认知功能，且具有一定安全性，值得在PSD患者的临床治疗中推广。

Abstract：

Objective To explore the effect of Huotan Qingqiao Jieyu decoction combined with antidepressant inthe treatment of post-stroke depression (PSD) . Methods A total of 80 patients with PSD admitted to Qingdao Haici HospitalAffiliated to Qingdao University from December 2019 to December 2020 were selected and divided into observation group andcontrol group by random number table method, with 40 cases in each group. The control group was given fluoxetine hydrochloridedispersible tablets on the basis of conventional treatment. The observation group was treated with Huotan Qingqiao Jieyu decoctionon the basis of the control group. Both groups were continuously treated for 2 months. The general data, clinical efficacy andTCM syndrome score, National Institutes of Health Stroke Scale (NIHSS) score, Mini-Mental State Examination (MMSE) score,IL-1, IL-2 and 5-hydroxytryptamine (5-HT) before and after treatment and the incidence of adverse reactions were comparedbetween the two groups. Results The clinical efficacy of observation group was better than that of control group (P < 0.05) .After treatment, the score of emotional depression, score of foreign body sensation in the throat, score of chest distress, scoreof tingling in the flank, score of dark purple or ecchymosis of tongue, score of thin and astringent pulse, and total score of TCMsyndrome in the two groups were lower than those before treatment respectively, and the score of emotional depression, score offoreign body sensation in the throat, score of dark purple or ecchymosis of tongue, score of thin and astringent pulse, total score ofTCM syndrome in the observation group were lower than those in the control group (P < 0.05) . After treatment, the NIHSS scoreof the two groups after treatment was lower than that before treatment, and the MMSE score was higher than that before treatment,respectively, NIHSS score in observation group was lower than that of control group, MMSE score was higher than that of controlgroup (P < 0.05) . After treatment, IL-1 and IL-2 in the two groups were lower than those before treatment, and 5-HT was higherthan that before treatment, respectively, and IL-1 and IL-2 in observation group were lower than those in control group, and 5-HT was higher than that in control group (P < 0.05) . There was no significant difference in the incidence of adverse reactions betweenthe two groups (P < 0.05) . Conclusion Huotan Qingqiao Jieyu decoction combined with antidepressant can improve the clinicalefficacy of PSD patients, improve the TCM syndrome, neurological function and cognitive function of patients, and has a certainsafety, which is worthy of promotion in the clinical treatment of PSD patients.

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