通腑解郁方治疗痰热扰神型卒中后抑郁临床研究OA

Objective:To observe the clinical efficacy of Tongfu Jieyu Prescription as adjuvant therapy for post-stroke depression(PSD)of phlegm-heat disturbing the spirit type.Methods:A total of 106 PSD patients of phlegm-heat disturbing the spirit type treated at Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University from January to September 2024 were randomly divided into a traditional Chinese medicine group(n=53,treated with Tongfu Jieyu Prescription)and a western medicine group(n=53,treated with Fluoxetine Hydrochloride Tablets).After eight weeks of treatment,clinical efficacy,incidence of adverse reactions,as well as depression scores[Hamilton Depression Scale(HAMD)and Self-Rating Depression Scale(SDS)],traditional Chinese medicine syndrome scores,Pittsburgh Sleep Quality Index(PSQI)scores,and neurotransmitter levels[5-hydroxytryptamine(5-HT),norepinephrine(NE),dopamine(DA)]before and after treatment were compared between the two groups.Results:After treatment,the total effective rate was 84.91%(45/53)in the traditional Chinese medicine group and 79.25%(42/53)in the western medicine group,with no significant difference(P＞0.05).HAMD and SDS scores decreased in both groups(P＜0.05),with no significant difference between the two groups(P＞0.05).The traditional Chinese medicine syndrome scores(primary symptoms,secondary symptoms,and total scores)decreased in both groups(P＜0.05),with lower scores in the traditional Chinese medicine group(P＜0.05).PSQI scores decreased in both groups(P＜0.05),with lower scores in the traditional Chinese medicine group(P＜0.05).Levels of 5-HT,NE,and DA increased in both groups(P＜0.05),with higher NE and DA levels in the traditional Chinese medicine group(P＜0.05);no significant difference was found in 5-HT levels between groups(P＞0.05).During treatment,the incidence of adverse reactions was 3.77%(2/53)in the traditional Chinese medicine group and 20.75%(11/53)in the western medicine group,showing a significant difference(P＜0.05).Conclusion:Tongfu Jieyu Prescription can regulate serum neurotransmitter levels,alleviate depressive symptoms,improve traditional Chinese medicine syndrome manifestations and sleep quality,and enhance clinical efficacy in PSD patients of phlegm-heat disturbing the spirit type,and has relatively fewer adverse reactions.