舒肝解郁膠囊聯合抗抑郁藥治療腦卒中后抑郁癥的效果

田樂 張慧如 王毅 王建俊 倪晶晶 景蘭

[摘要] 目的 觀察舒肝解郁膠囊聯合抗抑郁藥治療腦卒中后抑郁癥的效果。 方法 選取2016年7月～2018年7月在內蒙古自治區精神衛生中心治療的腦卒中后抑郁癥（PSD）患者128例，按照隨機數字表法將其分為對照組和觀察組，每組64例。對照組行抗抑郁常規治療，觀察組在抗抑郁藥基礎上聯合舒肝解郁膠囊治療，兩組均治療6周。以漢密頓抑郁量表（HAMD）為依據，評估療效及抑郁程度;采用美國國立衛生研究院神經功能缺損量表（NIHSS）評估神經功能;參照住院患者護理人員觀察量表（NOSIE）評定生活質量;觀察兩組不良反應。 結果 觀察組6周總有效率顯著高于對照組（P < 0.01）;觀察組6周后NIHSS評分低于對照組，差異有高度統計學意義（P < 0.01）;觀察組6周后HAMD評分低于對照組（P < 0.01）;兩組不良反應發生率比較，差異無統計學意義（P > 0.05），兩組均表現出輕微的惡心、頭痛、便秘等反應，2～3 d后自行消退;觀察組治療后抑郁、個人衛生、社會興趣、社會能力評分均低于對照組（P < 0.01）。 結論 PSD采用舒肝解郁膠囊與抗抑郁藥聯合治療的效果確切，能緩解抑郁癥狀，改善神經功能，提升生活質量，僅出現輕微的頭痛、惡心等反應，無嚴重不良反應，安全有效。

[關鍵詞] 腦卒中后抑郁癥;舍曲林;艾司西酞普蘭;神經功能;生活質量

[中圖分類號] R743.3? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-7210（2019）07（b）-0080-04

Effects of Shugan Jieyu Capsules combined with antidepressant in the treatment of post-stroke depression

TIAN Le? ?ZHANG Huiru? ?WANG Yi? ?WANG Jianjun? ?NI Jingjing? ?JING Lan

Department of Neurology， Inner Mongolia Mental Health Center， Inner Mongolia Autonomous Region， Huhhot? ?010020， China

[Abstract] Objective To observe the effect of Shugan Jieyu Capsules combined with antidepressant in the treatment of post-stroke depression. Methods From July 2016 to July 2018， 128 patients with post-stroke depression （PSD） treated in the Inner Mongolia Mental Health Center were selected and divided into control group and observation group according to random number table method， with 64 patients in each group. The control group received conventional antidepressant treatment， and the observation group was treated with Shugan Jieyu Capsules on the basis of antidepressant. Both groups were treated for 6 weeks. Hamilton depression rating scale （HAMD） was used to evaluate the efficacy and depression degree. Neurological function was assessed using the National Institutes of health stroke scale （NIHSS）. Quality of life was assessed by referring to the nurses′ observation scale for inpatient evaluation （NOSIE）. Adverse reactions were observed in the two groups. Results The total effective rate of observation group was significantly higher than control group （P < 0.01）. After 6 weeks， the NIHSS score of the observation group was lower than that of the control group， and the difference was highly statistically significant （P < 0.01）. HAMD scores in the observation group after 6 weeks were lower than those in the control group （P < 0.01）. There was no statistically significant difference in the rate of adverse reactions between the two groups （P > 0.05）. Both groups showed mild nausea， headache， constipation and other reactions， which spontaneously subsided after 2-3 days. The scores of depression， personal hygiene， social interest and social ability of the observation group were lower than those of the control group （P < 0.01）. Conclusion The combined treatment of Shugan Jieyu Capsules and antidepressant for PSD has a definite effect， which can relieve the symptoms of depression， improve neurological function and the quality of life. Only mild headache， nausea and other reactions occur， with no serious adverse reactions， it is safe and effective.

[Key words] Post-stroke depression; Sertraline; Escitalopram; Neurological function; Quality of life

腦卒中后抑郁癥（post-stroke depression，PSD）是一種神經精神并發癥，在腦卒中并發癥中極為多見[1]，但50%～80%的PSD未被臨床做出診斷[2]，臨床應及早規范治療PSD患者[3]。目前，臨床醫治以抗抑郁藥品為主，如TCAs類、SSRIs類等，其中SSRIs類抗抑郁藥應用最廣，包括氟西汀等[4]。近年來，中藥合成藥品——舒肝解郁膠囊在抑郁類等精神疾病廣泛應用，且療效可觀，副作用少。為此，本研究選擇128例PSD患者為研究對象，觀察抗抑郁藥與舒肝解郁膠囊的聯合效果，現報道如下：

1 資料與方法

1.1 一般資料

選取內蒙古自治區精神衛生中心（以下簡稱“我院”）神經內科2016年7月～2018年7月醫治的128例PSD患者。……