论文部分内容阅读
目的探讨中药辅助氟西汀治疗脑卒中后抑郁的疗效及对药物依赖性的影响。方法选取2012年8月至2014年8月脑卒中后抑郁住院治疗患者120例,采用随机数字对照表分为观察组与对照组,每组60例。对照组给予氟西汀20 mg/d口服,1次/d;观察组在对照组基础上给予六郁汤加味水煎300 ml口服,分2次用药,1剂/d。30 d为一个疗程,均治疗两个疗程。评估两组临床疗效及药物副作用;治疗前后行中医症状评分、汉密尔顿抑郁量表(HAMD)评分、日常生活能力ADL量表(Barthel指数)评分,测定肿瘤坏死因子-α(TNF-α)、重组人白介素(IL)-1β及IL-6水平。结果观察组治疗有效率为91.67%,显著高于对照组78.33%,差异具有统计学意义(P<0.05);观察组治疗后精神不振、失眠多梦、忧郁不畅、不思饮食评分均显著低于对照组(P均<0.05);观察组治疗后HAMD评分显著低于对照组,ADL评分显著高于对照组(P均<0.05);观察组治疗后TNF-α、IL-1β、IL-6水平均显著低于对照组(P<均0.05)。两组治疗后呕吐、皮疹、头晕、药物依赖性发生率无明显差异(P均>0.05)。结论六郁汤加味辅助氟西汀治疗脑卒中后抑郁能够有效缓解或消除抑郁情绪,提高临床疗效。
Objective To investigate the curative effect of drug-assisted fluoxetine on post-stroke depression and its dependence on drug dependence. Methods A total of 120 hospitalized patients with post-stroke depression in our hospital from August 2012 to August 2014 were selected and randomly divided into observation group and control group with 60 cases in each group. The control group was given fluoxetine 20 mg / d orally once a day. The observation group was given Luohuang decoction 300 ml orally on the basis of the control group with 2 times of medication and 1 dose / d. 30 d for a course of treatment, are treated for two courses. The curative effect and drug side effects were evaluated before and after treatment. The Chinese medicine symptom scores, Hamilton Depression Rating Scale (HAMD) score and ADL Scale (Barthel Index) were measured before and after treatment. The levels of tumor necrosis factor-α (TNF- Human interleukin (IL) -1β and IL-6 levels. Results The effective rate of treatment in observation group was 91.67%, which was significantly higher than that in control group (78.33%), the difference was statistically significant (P <0.05). After treatment, the observation group had sluggish mood, insomnia and depression, (P <0.05). The HAMD score of the observation group was significantly lower than that of the control group, and the ADL score was significantly higher than that of the control group (all P <0.05). After treatment, the levels of TNF-α, IL-1β, IL -6 levels were significantly lower than the control group (P <0.05). There was no significant difference in the incidence of vomiting, rash, dizziness and drug dependence between the two groups (all P> 0.05). Conclusion Liuyu Decoction supplemented fluoxetine in the treatment of post-stroke depression can effectively relieve or eliminate the depression and improve the clinical curative effect.