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贺海霞,王宇红,蔺晓源,李丹丹,佘颜.黄连温胆汤加味治疗卒中后抑郁症的临床研究[J].湖南中医药大学学报,2019,39(3):390-394[点击复制] |
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| 黄连温胆汤加味治疗卒中后抑郁症的临床研究 |
| 贺海霞,王宇红,蔺晓源,李丹丹,佘颜 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007;湖南省中药粉体与创新药物省部共建国家重点实验室培育基地, 湖南 长沙 410208;湖南中医药大学中医学国内一流建设学科, 湖南 长沙 410208;湖南中医药大学第一附属医院, 湖南 长沙 410007;湖南中医药大学中医学国内一流建设学科, 湖南 长沙 410208;湖南中医药大学, 湖南 长沙 410208) |
| 摘要: |
| 目的 分析黄连温胆汤加味对卒中后抑郁症（post-stroke depression，PSD）患者抑郁状态、认知功能障碍、神经功能及血液流变学指标的影响。方法 回顾性收集本院诊治的PSD患者88例，分为对照组和观察组各44例。对照组予以常规神经内科治疗，配合心理疏导，观察组在对照组基础上予以黄连温胆汤加味治疗，观察比较2组抑郁状态、认知功能障碍、神经功能及血液流变学指标等。结果 2组患者在治疗2周及4周后，HAMD评分、NIHSS评分均低于治疗前，且观察组明显低于对照组（P<0.05）；而两组MMSE评分均比治疗前升高（P<0.05），且观察组明显高于对照组（P<0.05）；经1个月治疗后，2组全血黏度、红细胞沉降等指标均比治疗前降低（P<0.05），且观察组降低程度比对照组明显（P<0.05）。疗效上观察组总有效率为86.37%，明显高于对照组的69.18%（P<0.05）。结论 对PSD患者实施神经内科常规治疗、心理疏导，联合黄连温胆汤加味有助于降低其认知功能障碍、改善患者情绪、稳定血液流变学指标、促进神经功能恢复，疗效确切，值得临床开展应用。 |
| 关键词: 卒中后抑郁 黄连温胆汤 抑郁状态 认知功能障碍 神经功能 血液流变学指标 |
| DOI：10.3969/j.issn.1674-070X.2019.03.023 |
| 投稿时间：2018-05-20 |
| 基金项目:国家科技重大专项课题（2017ZX09309026）；湖南中医药大学2017中医内科重大疾病防治及转化教育部重点实验室开放基金项目（ZYNK201707） |
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| A Clinical Study of Modified Huanglian Wendan Decoction in the Treatment of Post-stroke Depression |
| HE Haixia,WANG Yuhong,LIN Xiaoyuan,LI Dandan,SHE Yan |
| (The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;Training Bases, Hunan Key Laboratory of Chinese Materia Medica Powder and Innovative Drugs Established by Province and Ministry, Changsha, Hunan 410208, China;The National First-Class Construction Discipline of Chinese Medicine in Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;The National First-Class Construction Discipline of Chinese Medicine in Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| Objective To analyze the effects of modified Huanglian Wendan Decoction on depression, cognitive dysfunction, neurological function, and hemorheological indices in patients with post-stroke depression. Methods Eighty-eight patients with post-stroke depression who were diagnosed and treated in our hospital were retrospectively enrolled and equally divided into control group and observation group. Both groups received conventional neurological treatment combined with psychological counseling. The observation group received additional treatment with modified Huanglian Wendan Decoction. Depression, cognitive dysfunction, neurological function, and hemorheological indices were compared between the two groups. Results After 2 and 4 weeks of treatment, the scores for the Hamilton Depression Rating Scale and National Institutes of Health Stroke Scale were reduced in both groups and were significantly lower in the observation group than in the control group (P<0.05); the Mini-Mental State Examination score was significantly elevated in both groups (P<0.05) and was significantly higher in the observation group than in the control group (P<0.05). After one month of treatment, the whole blood viscosity and erythrocyte sedimentation rate were significantly reduced in both groups (P<0.05); the observation group had significant greater reductions in the above indices than the control group (P<0.05). The overall response rate was significantly higher in the observation group than in the control group (86.37% vs 69.18%, P<0.05). Conclusion Conventional neurological treatment and psychological counseling combined with modified Huanglian Wendan Decoction can improve cognitive function and emotion, stabilize hemorheological indices, and promote the recovery of neurological function in the treatment of patients with post-stroke depression, which holds promise for clinical application. |
| Key words: post-stroke depression Huanglian Wendan Decoction depression cognitive dysfunction neurological function hemorheological index |
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