标题：柴胡疏肝汤治疗缺血性脑卒中后抑郁的效果评价

      作者：刘小红，贾文智，赵小娅，鲍晓    岐山县中医医院内科，陕西 宝鸡 722400

      卷次： 2019年30卷22期

      【摘要】 目的 探讨柴胡疏肝汤治疗缺血性脑卒中后抑郁的临床效果。方法 选择2018年1~12月期间岐山县中医医院内科收治的128例缺血性脑卒中后抑郁患者为研究对象，根据随机数表法将患者分为观察组和对照组各64例，对照组患者在常规治疗的基础上应用氟西汀，观察组则在对照组患者治疗基础上联合应用柴胡疏肝汤，疗程均为12周。分别于治疗前、治疗4周和12周后使用汉密尔顿抑郁量表(HAMD)评价患者的抑郁严重程度，采用美国国立卫生研究院卒中量表(NIHSS)评价患者的神经功能缺损，采用功能独立性评定量表(FIM)评价日常生活活动能力。结果 治疗前，两组患者的HAMD评分、NIHSS评分、FIM评分比较，差异均无统计学意义(P>0.05)；治疗4周和 12周后，观察组患者的HAMD评分、NIHSS评分、FIM评分分别为(17.43±2.24)分和(10.43±2.05)分、(11.28±2.19)分和(7.36±1.20)分、(73.35±7.72)分和(90.54±8.36)分，明显优于对照组的(19.56±1.26)分和(14.32±2.34)分、(67.41±6.38)分和(9.31±1.47)分、(67.41±6.38)分和(79.04±9.23)分，差异均有统计学意义(P<0.05)。结论 柴胡疏肝汤治疗缺血性脑卒中后抑郁可以有效改善患者的抑郁症状，促进神经功能缺损的恢复，提高患者的日常生活活动能力。
      【关键词】 脑卒中后抑郁；缺血性脑卒中；氟西汀；柴胡疏肝汤；神经功能缺损
      【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1003—6350（2019）22—2879—03

Evaluation of Chaihu Shugan Decoction in the treatment of post-stroke depression.
LIU Xiao-hong, JIA Wen-zhi,ZHAO Xiao-ya, BAO Xiao. Department of Internal Medicine, Daishan County Hospital of Traditional Chinese Medicine,Baoji 722400, Shaanxi, CHINA
【Abstract】 Objective To explore the clinical effect of Chaihu Shugan Decoction on post-stroke depression.Methods A total of 128 patients with post-stroke depression treated in Daishan County Hospital of Traditional ChineseMedicine from January 2018 to December 2018 were selected as the research subjects. According to the random numbertable method, the patients were randomly divided into two groups: observation group and control group, with 64 patientsin each group. The patients in control group were treated with fluoxetine on the basis of routine treatment, while the pa-tients in observation group were treated with Chaihu Shugan Decoction on the basis of control group. The course of treat-ment lasted 12 weeks. At 4 weeks and 12 weeks after treatment, Hamilton depression scale (HAMD) was used to assessthe severity of depression before treatment. The NIH Stroke Scale (NIHSS) was used to assess the neurological impair-ment, and the Function Independent Measure (FIM) was used to assess the activity of daily living. Results Beforetreatment, there was no significant difference in HAMD score, NIHSS score, and FIM score between the observationgroup and the control group (P>0.05). At 4 and 12 weeks after treatment, HAMD, NIHSS, and FIM scores of the obser-vation group were 17.43±2.24 and 10.43±2.05, 11.28±2.19 and 7.36±1.20, 73.35±7.72 and 90.54±8.36, respectively,which were significantly better than 19.56±1.26 and 14.32±2.34, 67.41±6.38 and 9.31±1.47, 67.41±6.38 and 79.04±9.23in the control group (P<0.05). Conclusion Chaihu Shugan Decoction can effectively improve the depressive symp-toms, promote the recovery of neurological deficits, and improve the daily living ability of patients with post-stroke de-pression.
      【Key words】 Post-stroke depression; Ischemic stroke; Fluoxetine; Chaihu Shugan Decoction; Neurological im-pairment