丹栀逍遥散对卒中后抑郁患者神经递质的调节作用研究

Effect of DanzhiXiaoyao San on Neurotransmitters in Patients with Post-Stroke Depression

摘要: 目的：观察丹栀逍遥散治疗卒中后抑郁(PSD)的临床疗效及神经递质的调节作用。方法：将我院收治的86例符PSD患者随机按数字表法分为观察组和对照组。两组患者均给予基础治疗，对照组在此基础上给予氟西汀治疗。观察组给予采用丹栀逍遥散治疗。连续治疗6周。采用汉密尔顿抑郁量表-17 (HAMD-17)、美国国立卫生研究院卒中量表(NHISS)、中医证候评分和日常生活活动能力量表(ADL)评分评定抑郁程度和生活质量，观察并比较两组患者的5-羟色胺(5-HT)、去甲肾上腺素(NE)、多巴胺(DA水平)。结果：治疗后观察组临床疗效优于对照组(Z = 2.384, P < 0.01)；治疗后观察组患者HAMD-17和NHISS、中医证候评分低于对照组(P < 0.01)；观察组患者血清5-HT，DA和NE以及BDNF水平均高于对照组(P < 0.01)。结论：丹栀逍遥散可降低PSD患者抑郁程度，缓解抑郁症状，调节神经递质表达，促进了脑神经组织的修复，提高日常生活活动能力，值得临床使用。

Abstract: Objective: To observe the regulation of neurotransmitters and the clinical efficacy of DanzhiXiaoyao San in the treatment of post-stroke depression (PSD). Methods: 86 patients with PSD were randomly divided into the observation group and the control group. Two groups of patients were given basic treatment; the control group was given fluoxetine treatment on this basis. The obser-vation group was treated with DanzhiXiaoyao San, for 6 weeks. Depression and quality of life were assessed by Hamilton Depression Scale-17 (HAMD-17), National Institutes of Health Stroke Scale (NHISS), Chinese Medicine Syndrome Score and Activity in Daily Life Scale (ADL). The levels of se-rotonin (5-HT), norepinephrine (NE) and dopamine (DA) were observed and compared between the two groups. Results: After treatment, the clinical efficacy of the observation group was better than the control group (Z = 2.384, P < 0.01); the scores of HAMD-17, NHISS and TCM syndromes of the observation group were lower than the control group (P < 0.01); the serum levels of 5-HT, DA, NE and BDNF of the observation group were higher than the control group (P < 0.01). Conclusion: DanzhiXiaoyao San can reduce the degree of depression, alleviate depressive symptoms, regulate the expression of neurotransmitters, promote the repair of brain nerve tissue and improve the ability of daily living in patients with PSD, which is worthy of clinical use.