摘要
目的:观察理气解郁方合认知行为疗法治疗老年脑卒中后抑郁的临床疗效。方法:收集120例老年脑梗伴抑郁症状患者随机分为治疗组和对照组各60例。对照组予脑卒中常规西医治疗(防治脑水肿,调整血压,脑细胞保护,对症、支持等)。治疗组在此基础上给予中医药复方制剂(理气活血解郁汤)结合认知行为疗法治疗,90 d后予汉密尔顿抑郁量表(HAMD)评分、抑郁自评量表(SDS)、中医症候评分表得分评定疗效,并观察血液流变学检测各项指标变化。结果:(1)治疗组与对照组比较治疗90 d后汉密尔顿抑郁量表(HAMD)评分、Zung,s抑郁自评量表(SDS)评分、中医症候评分表评分对比有显著性差异(P<0.01);(2)入组时两组老年脑梗伴抑郁症状患者的抑郁症状(HAMD量表分)与全血还原黏度(高切、中切)、红细胞聚集指数、红细胞刚性指数等指标都呈显著正相关(P<0.05～0.01);(3)治疗组经中医药治疗90天后全血黏度(120s-1、70s-1和30s-1)、与全血还原黏度(高切、中切)、红细胞聚集指数、红细胞刚性指数等指标的变化值与汉密尔顿抑郁量表的减分值呈显著正相关(P<0.05～0.01)。结论:理气解郁方合认知行为疗法治疗老年脑卒中后抑郁的临床疗效显著;老年脑卒中抑郁症患者症状与血液流变学改变的关系密切,其高黏滞的程度与抑郁症状平行,通过动态观察血液流变学改善情况与疾病好转相关程度,为中医药治疗老年脑梗死患者抑郁症状的疗效提供了现代科学依据。
Objective ： To observed the clinical effect of patients with geriatric depression after stroke with regulating Qi and activating blood circulation formula combined with cognitive behavior therapy, Method：120 patients with cerebral in- farction depressive symptoms were stochasticly divided into two groups （.treatment group and contrast group） ,60 cases in each group. Contrast group was used the common Western medical therapy （preventing and treating cerebral hydroncus, regulating blood pressure, protecting cerebrum cell, suiting the remendy to case, supported treatment, etc ）. Treatment group was used Regulating Qi and Activating Blood Circulation Formula combined with cognitive behavior therapy based on the common Western medical therapy. The effect was assessed by depression scale（HAMD） score, Zung~ self- rating scale（ SDS）score,TCM symptom,grade chart after 90 days. And the hemorrheology indxes changes were observed. Re- sults ： （ 1 ） After 90 days, there was significant distinction between treatment group and contrast group in depression scale （HAMD）, Zungg self- rating scale（SDS） ,TCM symptom grade chart and hemorrheology indexs（ P 〈 0.01 ）. （2）There was a positive correlation between depressive symptoms （ HAMD scale score） and the indexes of whole blood viscosity （120s-1 ,70s-1 and 30s-1 ）, whole blood viscosity （high cut, reduction in low shear cut and red）, RBC deposit of patients in two groups when they were selected（P 〈 0.05 -0.01 ）. （3）There was a positive correlation between the indexes of whole blood viscosity （ 120^-＇ ,708- ＇ and 303-1 ） , whole blood viscosity （ high cut, reduction in low shear）, RBC deposit changed score and the depression scale（HAMD） reduced score of the patients with cerebral infarction depressive symp- toms after 90 days of TCM therapy（P 〈0. 05 ,P 〈0. 01 ）. Conclusion：It had a significant effect for elderly patients with cer- ebral infarction depressive symptoms with Regulating Qi and Activating Blood Circulation Formula combined with cognitive behavior therapy. There was a close relationship between cerebral infarction depressive symptoms of elderly patients and the change of hemorrheology. The high viscous of blood was in parallel with the depressive symptoms. It provided better scien- tific evidence for the clinical effect for elderly patients with cerebral infarction depression symptoms by TCM therapy.
出处
《中华中医药学刊》
CAS
2013年第4期733-736,共4页
Chinese Archives of Traditional Chinese Medicine
基金
国家中医药管理局中医药科学研究基金计划资助项目(2011ZB117)
关键词
脑梗死
抑郁症
中医药治疗
认知行为治疗
血液流变学
高黏滞血症
cerebral infarction
depressive symptoms
TCM therapy
cognitive behavior therapy
hemorrheology
high viscous of blood
