摘要
目的探讨旋覆理血汤治疗老年肝郁脾虚型卒中后抑郁(PSD)的疗效,为临床治疗提供指导。方法设计前瞻性随机对照试验,随机将108例PSD患者分为对照组和观察组,每组54例。均常规阿托伐他汀调脂治疗,阿司匹林抗血小板活化,并给予中成药活血化瘀治疗和专业康复训练。对照组在此基础上给予帕罗西汀治疗8周,观察组采用旋覆理血汤联合帕罗西汀治疗8周。从疗效、中医证候积分、汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)评分、生活质量和不良反应比较上述两种方法治疗老年肝郁脾虚型PSD的应用价值。结果观察组治疗有效率高于对照组(P<0.05),治疗后胸胁胀满,脘痞嗳气,食欲下降、情绪抑郁或思虑过度,善太息,易疲劳中医证候积分、HAMD、SDS评分低于对照组(P<0.05),健康状况调查简表(SF-36)各项评分和总评分均高于对照组(P<0.05),药物相关不良反应发生率低于对照组(P<0.05)。结论旋覆理血汤联合帕罗西汀治疗老年肝郁脾虚型PSD可更有效改善患者临床症状,提高生活质量,降低药物不良反应,疗效优于单独帕罗西汀治疗。
Objective To investigate the therapeutic effects of Xuanfulixue decoction in treating post-stroke depression(PSD)with liver-spleen deficiency type in elderly patients.Methods A prospective randomized controlled trial was designed,and 108 patients with PSD were randomly divided into control group(n=54)and observation group(n=54).The patients in both groups were conventionally treated by atorvastatin for lipid regulation and aspirin for anti-platelet activation,on that basis,the patients in control group were treated by paroxetine,however,the patients in observation group were treated by Xuanfulixue decoction combined with paroxetine,with a treatment course of 8 weeks for both groups.The therapeutic effect,TCM symptom score,Hamilton Depression Scale(HAMD),Self-rating Depression Scale(SDS),life quality and adverse reactions were observed and compared between the two groups.Results The effective rate in observation group(92.59%)was significantly higher than that(77.78%)in control group(P<0.05).The TCM symptom scores including fullness of chest and flank,belching of epigastric,loss of appetite,depression or over thinking,as well as HAMD scores and SDS scores in observation group were significantly lower than those in control group(P<0.05),however,the scores of SF36 and total score in observation group were significantly higher than those in control group(P<0.05).In addition the incidence of drug-related adverse effect in observation group was significantly lower than that in control group(P<0.05).Conclusion Xuanfulixue decoction combined with paroxetine can effectively improve the clinical symptoms,improve the quality of life,which can decrease the drug-related adverse reactions in treating PSD with liver-spleen deficiency type in elderly patients,and its curative effects are superior to those of simple paroxetine.
作者
侯丽敏
刘志芳
杨德志
谢琛
贾亚莲
HOU Limin;LIU Zhifang;YANG Dezhi(The First Affiliated Hospital of Xingtai Medical High-class Special School,Hebei,Xingtai 054000,China)
出处
《河北医药》
CAS
2021年第6期915-917,921,共4页
Hebei Medical Journal
关键词
旋覆理血汤
帕罗西汀
肝郁脾虚型
卒中后抑郁
疗效
不良反应
Xuanfulixue decoction
paroxetine
liver depression and spleen deficiency type
post-stroke depression
curative effects
adverse reactions
