【摘要】：目的:探討解郁安神顆粒合鹽酸帕羅西汀片治療缺血性腦中風(fēng)后抑郁癥的療效以及對(duì)血清白細(xì)胞介素(IL)-6,IL-23,腫瘤壞死因子-α(TNF-α),去甲腎上腺素(NE)和5-羥色胺(5-HT)水平的影響。方法:篩選94例缺血性腦中風(fēng)后抑郁癥患者,按數(shù)字表法將所有病例隨機(jī)分為觀察組48例和對(duì)照組46例;兩組患者根據(jù)《中國腦卒中康復(fù)治療指南》給予常規(guī)治療;對(duì)照組口服鹽酸帕羅西汀片,初始劑量20 mg·d-1,每周以10 mg遞增,最大劑量不超過40 mg·d-1。觀察組在對(duì)照組治療的基礎(chǔ)上給予解郁安神顆粒,5 g/次,2次/d,沖服。兩組患者均連續(xù)治療6周。比較兩組患者漢密爾頓抑郁(HAMD)量表評(píng)分,HAMD量表因子評(píng)分及臨床療效;檢測(cè)兩組患者血清IL-6,IL-23,TNF-α,NE和5-HT水平。結(jié)果:觀察組治療后3周和6周HAMD量表評(píng)分分別低于對(duì)照組同時(shí)點(diǎn)(P0.01);觀察組治療后HAMD量表各因子評(píng)分明顯低于對(duì)照組(P0.01);觀察組的臨床總有效率為91.67%,高于對(duì)照組的71.74%(P0.05);治療后觀察組血清IL-6,IL-23和TNF-α水平均低于對(duì)照組,NE和5-HT水平均高于對(duì)照組,比較差異有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論:解郁安神顆粒合鹽酸帕羅西汀片能提高缺血性腦中風(fēng)后抑郁癥的治療,其治療效果可能與下調(diào)患者血清IL-6,IL-23,TNF-α及上調(diào)NE,5-HT水平有關(guān)。
[Abstract]:Objective: to investigate the efficacy of Jieyu Anshen granule combined with paroxetine hydrochloride in the treatment of depression after ischemic stroke and the serum levels of interleukin (IL)-6 and tumor necrosis factor- 偽 (TNF- 偽). Effects of norepinephrine on the levels of (NE) and 5-hydroxytryptamine (5-HT). Methods: 94 patients with depression after ischemic stroke were randomly divided into observation group (n = 48) and control group (n = 46). In the control group, paroxetine hydrochloride tablets were given orally at an initial dose of 20 mg d ~ (-1), increasing at a weekly rate of 10 mg, with a maximum dose of less than 40 mg d ~ (-1). The observation group was treated with Jieyu Anshen granule, 5 g / time, 2 times / d, on the basis of treatment in the control group. The patients in both groups were treated continuously for 6 weeks. The scores of Hamilton depression (HAMD) scale, HAMD scale factor score and clinical efficacy were compared between the two groups, and the serum IL-6,IL-23,TNF- 偽, NE and 5-HT levels in the two groups were measured. Results: the scores of HAMD at 3 and 6 weeks after treatment in the observation group were lower than those in the control group (P0.01), and the scores of the factors of the HAMD scale in the observation group were significantly lower than those in the control group (P0.01). The total effective rate of the observation group was 91.67%, which was higher than that of the control group (71.74%) (P0.05). After treatment, the levels of serum IL-6,IL-23 and TNF- 偽 in the observation group were lower than those in the control group, and the levels of NE and 5-HT were higher than those in the control group (P0.01). Conclusion: Jieyu Anshen granule combined with paroxetine hydrochloride can improve the treatment of depression after ischemic stroke, and its therapeutic effect may be related to the down-regulation of serum IL-6,IL-23,TNF- 偽 and up-regulation of NE,5-HT level.
【作者單位】： 重慶市中醫(yī)院;貴陽中醫(yī)學(xué)院第二附屬醫(yī)院;
【基金】：貴州省中醫(yī)藥管理局中醫(yī)藥、民族醫(yī)藥科學(xué)技術(shù)課題(QZYY2011-29)
【分類號(hào)】：R743.3;R749.4
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本文編號(hào)：2423594