本文選題：逐瘀開(kāi)郁化痰湯 + 舍曲林　； 參考：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：研究目的:本研究采用逐瘀開(kāi)郁化痰湯治療缺血性腦卒中后抑郁(IPSD),通過(guò)與西藥舍曲林組比較,客觀評(píng)估逐瘀開(kāi)郁化痰湯治療缺血性腦卒中后抑郁(IPSD)的療效及對(duì)改善神經(jīng)功能的影響程度,為治療缺血性腦卒中后抑郁(IPSD)積累經(jīng)驗(yàn)。研究方法:將2016年4月至20l6年12月湖北省中醫(yī)院花園山院區(qū)腦病科住院及門診,與納入準(zhǔn)則相符的IPSD病人共60例作為研究對(duì)象。確診后隨機(jī)分治療組(中藥組)與對(duì)照組(舍曲林組),每組30例,分別對(duì)兩組患者治療前和治療4周后的中醫(yī)癥候積分、漢密爾頓抑郁量表(HAMD)積分、總有效率及神經(jīng)功能缺損(CSS)評(píng)分的變化進(jìn)行記錄評(píng)估,記錄的臨床數(shù)據(jù)采用SPSS19.0軟件加以統(tǒng)計(jì)學(xué)分析得出結(jié)論。研究結(jié)果:治療前兩組病人的年齡、性別、HAMD積分、CSS積分、中醫(yī)證候積分等進(jìn)行比較無(wú)明顯差異,經(jīng)過(guò)4周治療后抑郁癥狀較治療前有明顯改善:(1)兩組患者抑郁程度療效比較:治療4周之后,治療組總有效率86.77%,對(duì)照組的總有效率為76.33%,兩組組間比較差異明顯(P0.05),說(shuō)明兩組均能對(duì)患者的抑郁程度有改善,治療組療效高于對(duì)照組。(2)治療4周后,HAMD量表積分、CSS量表積分、中醫(yī)癥候積分對(duì)比均較用藥之前有下降(P0.01),治療組改善程度比對(duì)照組要高(P0.05),說(shuō)明兩組均可以改善HAMD量表積分、CSS量表積分、中醫(yī)證候積分,治療組在改善抑郁癥狀、神經(jīng)功能缺損及中醫(yī)證候程度上優(yōu)于西藥對(duì)照組。(3)安全性:在整個(gè)臨床治療期間,治療組都沒(méi)有出現(xiàn)重大藥物不良反應(yīng)事件。西藥對(duì)照組在治療后第3周,2例患者出現(xiàn)輕微的消化不良、口干、失眠等不良反應(yīng)。治療前后進(jìn)行的實(shí)驗(yàn)室檢驗(yàn)(血、尿、糞常規(guī),心電圖,血生化等)均未見(jiàn)明顯異常,提示治療組安全性良好,不良反應(yīng)機(jī)率小,逐瘀開(kāi)郁化痰湯組更安全。研究結(jié)論:逐瘀開(kāi)郁化痰湯治療缺血性卒中后抑郁(IPSD)經(jīng)臨床觀察療效顯著,不僅使患者卒中后抑郁的癥狀明顯好轉(zhuǎn),還有助于病人的神經(jīng)功能的康復(fù),降低致殘率,無(wú)不良反映及藥物依賴性或成癮性,與西藥組治療比較,能取得更好的臨床治療效果,提示中藥在IPSD的治療上具有較好的優(yōu)勢(shì)。
[Abstract]:Objective: to study the effect of Zhuyu Kaiyu Huatan decoction on depression after ischemic stroke and to compare it with sertraline group. Objective to evaluate the efficacy of Zhuyu Kaiyu Huatan decoction in treating depression after ischemic stroke (IPSDs) and its influence on improving neurological function, so as to accumulate experience in the treatment of depression after ischemic stroke. Methods: from April 2016 to December 20l6, 60 cases of IPSD patients in Huayuan Mountain Hospital of Hubei traditional Chinese Medicine Hospital were studied. After diagnosis, they were randomly divided into treatment group (Chinese medicine group) and control group (sertraline group, 30 cases in each group). The scores of TCM symptoms and Hamilton Depression scale (Hamd) were measured before treatment and 4 weeks after treatment, respectively. The changes of total effective rate and neurological impairment score were recorded and evaluated. The clinical data were statistically analyzed by SPSS19.0 software. Results: there was no significant difference in age, sex, Hamd integral and CSS integral, TCM syndrome score between the two groups before treatment. After 4 weeks of treatment, the depressive symptoms were significantly improved in the two groups compared with those before treatment: after 4 weeks of treatment, the depressive degree of the patients in the two groups was better than that before treatment. The total effective rate of the treatment group was 86.77 and the total effective rate of the control group was 76.33. The difference between the two groups was significant (P 0.05), which indicated that both groups could improve the depression degree of the patients, and the curative effect of the treatment group was higher than that of the control group. The comparison of TCM symptom score was lower than that before medication, and the improvement degree of the treatment group was higher than that of the control group, indicating that both groups could improve the HAMD scale integral and CSS-scale integral, TCM syndrome score, and the treatment group was improving the depressive symptoms. Nerve function defect and TCM syndromes were superior to the western medicine control group in safety: there were no significant adverse drug reaction events in the treatment group during the whole clinical treatment period. In the control group, 2 patients had mild adverse reactions such as dyspepsia, dry mouth and insomnia at the 3rd week after treatment. The laboratory tests (blood, urine, stool routine, electrocardiogram, blood biochemistry, etc.) before and after treatment were not obviously abnormal, suggesting that the treatment group was safe, the probability of adverse reactions was small, and the treatment group was more safe. Conclusion: the curative effect of Zhuyu Kaiyu Huatan decoction on depression after ischemic stroke is remarkable. It not only improves the symptoms of depression after stroke, but also helps to rehabilitate the patients' neurological function and reduce the rate of disability. No adverse reactions, drug dependence or addiction, compared with the treatment of western medicine group, can achieve better clinical treatment effect, suggesting that Chinese medicine in the treatment of IPSD has a better advantage.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R277.7

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相關(guān)期刊論文 前10條

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本文編號(hào)：1825166