摘要
目的探讨脑卒中后抑郁症(PSD)(心脾两虚证)患者接受甘麦大枣汤合归脾汤加减治疗的临床效果,并采用高通量测序检测其肠道菌群变化。方法选取本院收治的120例PSD(心脾两虚证)患者,随机分为对照组和观察组,各60例,对照组给予常规西医治疗,观察组在此基础上给予甘麦大枣汤合归脾汤加减治疗。比较两组患者治疗前后神经功能缺损评分(NIHSS)和抑郁评分、抗抑郁疗效、不良反应发生情况及肠道菌群丰度差异。结果治疗前两组患者NIHSS和HAMD评分比较,差异无统计学意义(P>0.05),与治疗前相比,治疗后两组患者NIHSS和HAMD评分均降低(P<0.001),观察组均低于对照组(P<0.001)。比较两组患者抗抑郁疗效等级分布,差异具有统计学意义(Z=5.332,P=0.022),且观察组总有效率高于对照组(χ^2=6.000,P=0.014)。治疗前,观察组和对照组患者肠道菌群OTU数分别为653和658,独有个数分别为51和46,占各自OTU总数的7.81%和6.99%,差异无统计学意义(t=0.672,P=0.503),治疗后,观察组和对照组患者肠道菌群OTU数分别为498和552,独有个数分别为222和168,占各自OTU总数的44.58%和30.43%,与治疗前相比,两组患者肠道菌群OTU数目均降低(观察组:t=15.363,P<0.001;对照组:t=9.456,P<0.001),且观察组OTU数目低于对照组(t=9.084,P<0.001)。对照组和观察组不良发应总发生率分别为11.67%、8.33%,差异无统计学意义(χ^2=0.370,P=0.054)。结论甘麦大枣汤和归脾汤加减能够更好地修复PSD(心脾两虚证)患者神经功能损伤,缓解患者抑郁症状,具有更好地抗抑郁效果,有助于改善患者肠道菌群,安全可靠,值得推广应用。
Objective To explore the therapeutic effect of Ganmai-dazao decoction and Guipi decoction on patients with post-stroke depression(PSD)(heart and spleen deficiency syndrome)and its influence on intestinal flora.Methods One hundred and twenty patients with PSD(deficiency of heart and spleen)were randomly divided into two groups,60 cases in each group.The control group was treated with conventional western medicine,while the observation group was treated with Ganmai-dazao decoction and Guipi decoction.Before and after treatment,neurological impairment scores(NIHSS),depression scores,antidepressant efficacy,adverse reactions,and abundance of intestinal flora were compared between the two groups.Results There were no significant differences in NIHSS and HAMD scores between the two groups before treatment(P>0.05).Compared with those before treatment,the scores of NIHSS and HAMD in the two groups were lower after treatment(P<0.001),and those in the observation group were lower than those in the control group(P<0.001).There was a statistical difference between the two groups(Z=5.332,P=0.022),and the total efficiency rate in the observation group was higher than that in the control group(χ^2=6.000,P=0.014).Compared with that before treatment,the number of OTU in the intestinal flora in the two groups decreased(P<0.001),and the number of OTU in the observation group was lower than that in the control group(t=9.084,P<0.001).The total incidence of adverse reactions in the control group and observation group were 11.67%and 8.33%,respectively,with no significant difference(χ^2=0.370,P=0.054).Conclusion Ganmai-dazao decoction and Guipi decoction can effectively repair the neurological damage of PSD patients and relieve the symptoms of depression,which has better antidepressant effect,help to improve intestinal flora,and is safe and reliable.
作者
黄姗
杨昆鹏
万飞
徐小敏
张启宝
HUANG Shan;YANG Kunpeng;WAN Fei;XU Xiaomin;ZHANG Qibao(Chongqing Medical and Pharmaceutical College,Chongqing 401331,China;不详)
出处
《中国微生态学杂志》
CAS
CSCD
2020年第10期1173-1176,1181,共5页
Chinese Journal of Microecology
基金
重庆市卫生健康委员会2019年市级中医药重点学科(针灸推拿学)建设项目(201843)
重庆市卫计委2017年度中医药科技项目(ZY201702125)。
关键词
甘麦大枣汤
归脾汤
脑卒中后抑郁症
肠道菌群
Ganmai-dazao decoction
Guipi decoction
Post-stroke depression
Intestinal microecology
