Clinical curative effect of Shugan Xiehuo Decoction in treating Qiyu Huahuo type post-stroke depression
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摘要:
目的 探讨疏肝泻火汤治疗气郁化火型脑卒中后抑郁(PSD)的临床疗效。 方法 将浙江中医药大学附属温州中医院2017年8月—2019年12月期间治疗的120例气郁化火型PSD患者纳入研究，按照随机数字表法分为观察组和对照组，每组60例。对照组患者应用盐酸舍曲林片治疗，观察组患者应用疏肝泻火汤治疗，治疗周期为6周，随访观察2组患者HAMD评分、NIHSS评分、Barthel指数评分及中医症候评分，并对2组患者治疗期间不良反应发生情况进行比较分析。 结果 (1) 2组患者治疗前HAMD评分、NIHSS评分、Barthel指数评分及中医症候评分之间差异无统计学意义(均P＞0.05)，治疗后均有所改善，且观察组改善程度显著优于对照组，差异有统计学意义(tHAMD评分=-2.467，P=0.015；tNIHSS评分=-5.707，P＜0.001；tBarthel指数评分=36.258，P＜0.001；t中医症候评分= -7.267，P＜0.001)；(2)观察组患者治疗期间不良反应发生率为8.33%，对照组为10.00%，2组相比差异无统计学意义(χ2=0.100，P=0.752)。 结论 疏肝泻火汤治疗气郁化火型PSD疗效较好，在改善患者抑郁症状的基础上，对其神经功能康复具有一定作用，进一步提高患者生活质量，且治疗过程中未见严重药物不良反应和药物成瘾性。 Abstract:Objective To explore the clinical efficacy of Shugan Xiehuo Decoction in treating Type of stagnated qi turning to fire post-stroke depression (PSD). Methods A total of 120 patients with Type of stagnated qi turning to fire PSD treated in Wenzhou Hospital of Traditional Chinese Medicine of Zhejiang University from August 2017 to December 2019 were included in this study. According to the random-number table method, the observation and control groups had 60 patients each. Patients in the control group were treated with sertraline hydrochloride tablets, whereas patients in the observation group were treated with Shugan Xiehuo Decoction for 6 weeks. Patients in the two groups were followed-up, and their HAMD score, NIHSS score, Barthel Index score, and TCM syndrome score were observed. The occurrence of adverse reactions during treatment was compared and analysed. Results (1) No statistically significant difference in HAMD score, NIHSS score, Barthel index score, and TCM syndrome score was observed between the two groups before treatment (all P>0.05). Improvement was observed after treatment, and this improvement was significantly higher in the observation group than in the control group (tHAMD score=-2.467, P=0.015; tNIHSS score=-5.707, P < 0.001; tBarthel index score=36.258, P < 0.001; tTCM syndrome score=-7.267, P < 0.001). (2) The incidence of adverse reactions was 8.33% in the observation group and 10.00% in the control group, with no significant difference between both groups (χ2=0.100, P=0.752). Conclusion Shugan Xiehuo Decoction has a definite effect on the treatment of Type of stagnated qi turning to fire PSD. On the basis of improving patients' depressive symptoms, it has a certain effect on their neurological rehabilitation and further improves patients' quality of life. No serious adverse drug reactions or drug addiction is observed during treatment. -
表 1 2组气郁化火型PSD患者治疗前后相关指标比较(x ±s, 分)
组别 例数 HAMD评分 NIHSS评分 Barthel指数评分 中医症候评分 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 观察组 60 19.15±6.18 10.35±3.05a 9.15±3.15 2.75±1.15a 41.02±12.15 94.45±0.96a 24.86±5.02 11.54±3.25a 对照组 60 19.54±8.21 12.05±4.38a 9.31±4.11 3.98±1.21a 40.28±11.89 84.15±1.98a 24.01±4.89 15.62±2.89a t值 -0.294 -2.467 -0.239 -5.707 0.337 36.258 0.940 -7.267 P值 0.769 0.015 0.812 ＜0.001 0.737 ＜0.001 0.349 ＜0.001 注：与治疗前比较，aP＜0.05。 
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