摘要
目的:探究甘麦大枣汤加味对脑卒中后抑郁(PSD)患者认知功能、神经递质及炎症介质的影响。方法:选取符合纳入标准的PSD患者200例,依据随机数字表随机分为研究组100例和对照组100例。对照组患者给予基础治疗,研究组在对照组基础上给予甘麦大枣汤加味治疗,均治疗8周。比较两组治疗前后认知功能(蒙特利尔认知功能评估量表,MoCA)、神经递质[γ-氨基丁酸(GABA)、谷氨酸(Glu)、天冬氨酸(Asp)]、炎症介质[肿瘤坏死因子-α(TNF-α)、高迁移率簇蛋白B1(HMGB1)、白介素-8(IL-8)]的变化情况和临床疗效。结果:研究组治疗总有效率(96%,96/100)高于对照组(81%,81/100),差异有统计学意义(P<0.05)。重复测量方差分析显示,两组患者治疗后MOCA评分均显著升高(P<0.01),且研究组治疗后MOCA评分高于对照组(P<0.01)。两组患者治疗后GABA水平均显著升高(P<0.01),Glu、Asp水平均显著降低(P<0.01),且研究组治疗后GABA水平高于对照组(P<0.01),Glu、Asp水平低于对照组(P<0.01)。两组患者治疗后DA、NE、5-HT水平均显著升高(P<0.01),且研究组治疗后DA、NE、5-HT水平高于对照组(P<0.01)。两组患者治疗后TNF-α、IL-8、HMGB1水平均降低(P<0.01),且研究组治疗后TNF-α、IL-8、HMGB1水平低于对照组(P<0.01)。结论:甘麦大枣汤加味可有效改善脑卒中后抑郁(PSD)患者认知功能,优化神经递质分泌合成,降低炎症反应。
Objective:To explore the effects of modified Ganmai Dazao Decoction on cognitive function,neurotransmitters and inflammatory mediators in patients with post-stroke depression(PSD).Methods:200 PSD patients met the inclusion criteria were randomly divided into the study group and the control group,with 100 cases in each group.The control group was given basic treatment;on which basis,the study group was also treated with modified Ganmai Dazao Decoction.After 8 weeks of treatment,cognitive function(Montreal Cognitive Function Assessment Scale,MoCA),neurotransmitters[γ-aminobutyric acid(GABA),glutamate(Glu),aspartate(Asp)]and inflammatory mediators[tumor necrosis factor-α(TNF-α),high mobility clusterin B1(HMGB1),interleukin-8(IL-8)]were compared between before and after the treatment in the two groups.The clinical efficacy was also compared between the two groups.Results:The total effective rate of the study group was 96%(96/100),which was significantly higher than 81%(81/100)of the control group(P<0.05).Repeated measures analysis of variance showed that the MOCA score was significantly increased after the treatment in the two groups(P<0.01),and the MOCA score in the study group was higher than that in the control group after the treatment(P<0.01).The level of GABA was significantly increased(P<0.01),whereas the levels of Glu and Asp were decreased after the treatment in the two groups(P<0.05);the level of GABA was higher(P<0.01),and the levels of Glu and Asp were lower in the study group than those in the control group(P<0.01).The levels of DA,NE and 5-HT were significantly increased after the treatment compared with those before the treatment in the two groups(P<0.01);the levels of DA,NE and 5-HT were higher in the study group than those in the control group after the treatment(P<0.01).The levels of TNF-α,IL-8 and HMGB1 were decreased after the treatment compared with those before the treatment in the two groups(P<0.01);the levels of TNF-α,IL-8 and HMGB1 were lower in the study group than those in the control group after the treatment(P<0.01).Conclusion:Modified Ganmai Dazao Decoction can effectively improve cognitive function,optimize neurotransmitter secretion and synthesis,and reduce inflammatory response in patients with PSD.
作者
王雪利
谢静红
蒋利魁
WANG Xuei;XIE Jinghong;JIANG Likui(Jiaozuo Hospital of Traditional Chinese Medicine,Jiaozuo 454150,China)
出处
《中医药信息》
2023年第6期66-70,共5页
Information on Traditional Chinese Medicine
关键词
脑卒中
抑郁
甘麦大枣汤加味
认知功能
神经递质
炎症介质
Stroke
Depression
Modified Ganmai Dazao Decoction
Cognitive function
Neurotransmitters
Inflammatory mediators
