摘要
目的:探讨解郁安神颗粒合盐酸帕罗西汀片治疗缺血性脑中风后抑郁症的疗效以及对血清白细胞介素(IL)-6,IL-23,肿瘤坏死因子-α(TNF-α),去甲肾上腺素(NE)和5-羟色胺(5-HT)水平的影响。方法:筛选94例缺血性脑中风后抑郁症患者,按数字表法将所有病例随机分为观察组48例和对照组46例;两组患者根据《中国脑卒中康复治疗指南》给予常规治疗;对照组口服盐酸帕罗西汀片,初始剂量20 mg·d-1,每周以10 mg递增,最大剂量不超过40 mg·d-1。观察组在对照组治疗的基础上给予解郁安神颗粒,5 g/次,2次/d,冲服。两组患者均连续治疗6周。比较两组患者汉密尔顿抑郁(HAMD)量表评分,HAMD量表因子评分及临床疗效;检测两组患者血清IL-6,IL-23,TNF-α,NE和5-HT水平。结果:观察组治疗后3周和6周HAMD量表评分分别低于对照组同时点(P<0.01);观察组治疗后HAMD量表各因子评分明显低于对照组(P<0.01);观察组的临床总有效率为91.67%,高于对照组的71.74%(P<0.05);治疗后观察组血清IL-6,IL-23和TNF-α水平均低于对照组,NE和5-HT水平均高于对照组,比较差异有统计学意义(P<0.01)。结论:解郁安神颗粒合盐酸帕罗西汀片能提高缺血性脑中风后抑郁症的治疗,其治疗效果可能与下调患者血清IL-6,IL-23,TNF-α及上调NE,5-HT水平有关。
Objective： To investigate the clinical efficacy of Jieyu Anshen particles combined with paroxetine hydrochloride tablets in treatment of depression after ischemic stroke its effects on levels of interleukin（ IL）-6,IL-23,tumor necrosis factor-α（ TNF-α）,norepinephrine（ NE） and 5-hydroxytryptamine（ 5-HT） in serum. Method： Ninety-four patients with depression after ischemic stroke in our hospital were elected and randomly divided into observation group（ 48 cases） and control group（ 46 cases） according to random number table. All patients in both groups were treated with conventional intervention according to ‘Guidelines for Stroke Rehabilitation in China ＇. Patients in control group orally took paroxetine hydrochloride tablets,20 mg / day at beginning,increased by 10 mg per week,and with a maximum dose≤40 mg / day. Patients in observation group were given with Jieyu Anshen particles based on the treatment of control group,5 g / time,bid. Patients in both groups were treated for 6 weeks. Scores of Hamilton＇s depression scale（ HAMD）,scores of HAMD factors,and clinical efficacy were compared between two groups. The levels of IL-6,IL-23,TNF-α,NE and 5-HT in serum were detected in both groups. Result： After 3 and 6 weeks＇ treatment,scores of HAMD scale in observation group were lower than those in control group（ P 〈0. 01）. Scores of HAMD factors in observation group were lower than those in control group after treatment（ P 〈0. 01）. The total effective rate was 91. 67% in observation group,higher than 71. 74% in control group（ P 〈0. 05）. After treatment,the levels of IL-6,IL-23,and TNF-α in serum of observation group were significantly lower,while NE and 5-HT levels were significantly higher than those of control group,with statistically significant differences（ P 〈0. 01）. Conclusion： Jieyu Anshen particles combined with hydrochloride tablets had definite efficacy in treatment of depression after ischemic stroke,and the therapeutic effect may be related with down-regulating the levels of IL-6,IL-23,TNF-α,and up-regulating NE and 5-HT levels in serum.
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2016年第13期177-181,共5页
Chinese Journal of Experimental Traditional Medical Formulae
基金
贵州省中医药管理局中医药
民族医药科学技术课题(QZYY2011-29)
关键词
解郁安神颗粒
盐酸帕罗西汀片
缺血性脑卒中
抑郁症
Jieyu Anshen particles
paroxetine hydrochloride tablets
ischemic stroke
depression
