厚朴七物汤联合帕罗西汀治疗肝郁脾虚型卒中后抑郁临床研究

Clinical Study of Houpo Qiwu Decoction Combined with Paroxetine for Post-Stroke Depression of Liver Stagnation and Spleen Deficiency Type

摘要:

目的：观察厚朴七物汤联合帕罗西汀治疗肝郁脾虚型卒中后抑郁（PSD） 的临床疗效。方法：选取2022年3月—2023年9月在广州中医药大学茂名医院脑病科住院治疗的80例肝郁脾虚型PSD患者作为研究对象，采用随机数字表法分为治疗组和对照组各40例。在研究过程中治疗组脱落4例，最终纳入36例；对照组脱落2例，最终纳入38例。治疗组采用厚朴七物汤联合帕罗西汀治疗，对照组仅采用帕罗西汀治疗，疗程均为1个月。比较2组临床疗效，以及治疗前后汉密尔顿抑郁量表评分（HAMD）、中医证候评分、胃肠疾病症状评分变化。结果：治疗后，治疗组总有效率为86.11%（31/36），对照组为65.79%（25/38），2组比较，差异有统计学意义（P＜0.05）。治疗后，2组HAMD评分均较治疗前降低（P＜0.05），且治疗组评分低于对照组（P＜0.05）；治疗组治疗前后差值亦大于对照组（P＜0.05）。治疗后，2 组中医证候评分均较治疗前降低（P＜0.05），且治疗组评分低于对照组（P＜0.05）；治疗组治疗前后差值亦大于对照组（P＜0.05）。治疗后，2组胃肠疾病症状评分均较治疗前降低（P＜0.05），且治疗组评分低于对照组（P＜0.05）；治疗组治疗前后差值亦大于对照组（P＜0.05）。结论：厚朴七物汤联合帕罗西汀治疗肝郁脾虚型PSD可提高临床疗效，改善中医证候、抑郁状态及胃肠功能。

Abstract:

Abstract：Objective：To observe the clinical effect of Houpo Qiwu Decoction combined with Paroxetine on poststroke depression （PSD） of liver stagnation and spleen deficiency type. Methods：A total of 80 PSD patients of liver stagnation and spleen deficiency type who were hospitalized in the Department of Encephalopathy，Maoming Hospital of Guangzhou University of Chinese Medicine from March 2022 to September 2023 were selected as the study subjects. They were divided into the treatment group and the control group by the random number table method，with 40 cases in each group. During the study，4 cases dropped out in the treatment group，and 36 cases were finally included. In the control group，2 cases dropped out，and 38 cases were finally included. The treatment group was treated with Houpo Qiwu Decoction combined with Paroxetine， and the control group was treated with Paroxetine only. The course of treatment was one month. The clinical effects，as well as the changes in Hamilton Depression Scale （HAMD） scores， traditional Chinese medicine syndrome scores and gastrointestinal disease symptom scores before and after treatment were compared between the two groups. Results：After treatment，the total effective rate was 86.11% （31/36） in the treatment group and 65.79% （25/38） in the control group，the difference being significant （P＜0.05）. After treatment， the HAMD scores in the two groups were decreased when compared with those before treatment （P＜0.05）， and the HAMD score in the treatment group was lower than that in the control group （P＜0.05）；the difference before and after treatment in the treatment group was also greater than that in the control group （P＜0.05）. After treatment， the traditional Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment （P＜0.05）， and the traditional Chinese medicine syndrome scores in the treatment group were lower than those in the control group （P＜0.05）；the difference before and after treatment in the treatment group was also greater than that in the control group （P＜0.05）. After treatment，the gastrointestinal disease symptom scores in the two groups were decreased when compared with those before treatment （P＜0.05），and the gastrointestinal disease symptom scores in the treatment group were lower than those in the control group （P＜0.05）；the difference before and after treatment in the treatment group was also greater than that in the control group （P＜0.05）. Conclusion：The therapy of Houpo Qiwu Decoction combined with Paroxetine can enhance the clinical effects on PSD of liver stagnation and spleen deficiency type，which can improve the traditional Chinese medicine syndromes，depressive state and the gastrointestinal function.