2019 年第 6 期 第 14 卷

健脾益气方联合氟哌噻吨美利曲辛片治疗卒中后抑郁症的效果观察

Effect of Jianpi Yiqi prescription combined with flupentixol and melitracen tablets on post-stroke depression

作者：张熠童卫杭胡霜霜原杰

英文作者：

单位：100088北京，中国人民解放军火箭军特色医学中心药学部（张熠、童卫杭、胡霜霜），感染性疾病科（原杰）

英文单位：

关键词：

英文关键词：

• 摘要：

• 【摘要】目的    探讨健脾益气方联合氟哌噻吨美利曲辛片治疗卒中后抑郁症（PSD）的效果。方法    选取2016年6月至2017年6月中国人民解放军火箭军特色医学中心收治的PSD患者80例，采用随机数字表法分为中西医结合组和西药组，各40例。西药组患者采用氟哌噻吨美利曲辛片治疗，中西医结合组患者采用健脾益气方联合氟哌噻吨美利曲辛片治疗。2组持续治疗12周。比较2组临床疗效，治疗前后汉密尔顿抑郁量表、斯堪迪纳维亚卒中量表、改良Barthel指数评分，血清多巴胺、去甲肾上腺素（NE）和5-羟色胺水平及药物不良反应情况。结果    中西医结合组抑郁症状和神经功能恢复的总有效率均明显高于西药组［92.5%(37/40)比75.0%(30/40)、97.5%(39/40)比72.5%(29/40)］（均P＜0.05）。治疗后，中西医结合组汉密尔顿抑郁量表与斯堪迪纳维亚卒中量表评分明显低于西药组，改良Barthel指数评分明显高于西药组，血清多巴胺、NE和5-羟色胺水平均明显高于西药组，差异均有统计学意义（均P＜0.05）。2组药物不良反应发生率比较差异无统计学意义（P=0.456）。结论    健脾益气方联合氟哌噻吨美利曲辛片治疗PSD的效果满意，有助于升高血清多巴胺、NE、5-羟色胺水平，缓解抑郁症状，改善神经功能恢复和日常生活活动能力，且安全性较好。

• 【Abstract】Objective    To analyze the therapeutic effect of Jianpi Yiqi prescription combined with flupentixol and melitracen tablets on post-stroke depression(PSD). Methods    Eighty patients with PSD were enrolled from June 2016 to June 2017 in Rocket Army Characteristic Medical Center of Chinese People′s Liberation Army. The patients were randomly allocated to combination group （combination of Chinese traditional and western medicine） and western medicine group, with 40 cases in each group. The western medicine group was treated with flupentixol and melitracen tablets; the combination group was treated with Jianpi Yiqi prescription, flupentixol and melitracen tablets; the treatments lasted for 12 weeks. Clinical efficacy, Hamilton Depression Scale(HAMD), Scandinavia Stroke Scale(SSS), modified Barthel index, serum dopamine, noradrenaline, 5-hydroxytryptamine levels and adverse drug reactions were analyzed. Results    Total effective rates of depressive symptoms and nerve function recovery in the combination group were significantly higher than those in the western medicine group［92.5%(37/40) vs 75.0%(30/40), 97.5%(39/40) vs 72.5%(29/40)］（P＜0.05）. After treatment, scores of HAMD and SSS in the combination group were significantly lower and modified Barthel index was significantly higher than those in the western medicine group; levels of serum dopamine, noradrenaline and 5-hydroxytryptamine in the combination group were significantly higher than those in the western medicine group (P＜0.05). There was no significant difference of adverse reactions between groups(P=0.456). Conclusion    Jianpi Yiqi prescription combined with flupentixol and melitracen tablets treating PSD can increase serum dopamine, noradrenaline and 5-hydroxytryptamine, alleviate depression symptoms, improve nerve function and daily activities.