世界中医药

目的:观察关“丹栀通竹方”治疗中风后抑郁症的临床。方法:选取2015年3月至2016年2月新乐市中医医院针灸科、康复科门诊、中风病病房收治的60例中风后抑郁患者，按就诊顺序编随机数字表法进行随机分为治疗组和对照组，每组30例。对照组在内科常规治疗基础上，口服盐酸氟西汀(20 mg，1次/d，治疗组在内科常规治疗基础上给予丹栀通竹方加减治疗。治疗前、治疗30 d和治疗60 d采用Fugl-Mayer评估量表(FMA)量表评估患者的偏瘫肢体运动功能;汉密顿抑郁量表(HAMD)量表评分对中风后患者进行抑郁评分评估;运用改良日常生活活动量表(mBI)评分以评估患者的生活质量及采用酶联免疫吸附试验(ELISA)检测脑源性神经营养因子(BDNF)。结果:2组治疗后FMA、mBI评分和BDNF均高于治疗前(P<0.05);与对照组比较，治疗组治疗30 d的FMA、mBI评分和BDNF均差异无统计学意义(P>0.05)，治疗60 d的FMA、mBI评分和BDNF均较高(P<0.05)。HAMD评分结果与之相反，BDNF的表达情况与HAMD量表评分呈负相关，Pearson相关系数为-0.949，P=0.000<0.05。结论:丹栀通竹方可明显改善PSD抑郁症状，并因此更进一步协助患者躯体功能恢复，而该方发挥疗效可能与上调BDNF有关。

English Summary:

To observe the effect of “Danzhi Tongzhu” in clinical treatment of depression after stroke. Methods:A total of 60 patients with post-stroke depression admitted in departments of acupuncture， rehabilitation and stroke disease of Xinle Hospital of Traditional Chinese Medicine from March 2015 to February 2016 were randomly divided into a treatment group and a control group according to the order of visits， with 30 patients in each group. Patients in the control group were given oral administration of fluoxetine hydrochloride (20 mg， 1 times a day) on the basis of routine medical treatment， while patients in the treatment group were given Danzhi Tongzhu on the same basis. Before treatment， 30 days and 60 days after treatment， Fugl-Mayer assessment scale (FMA) was used to assess the motor function of hemiplegic limbs of patients; the Hamilton depression scale (HAMD) was used to evaluate the depression of patients; activities of daily living scale (mBI) was used to assess the quality of life of patients and enzyme-linked immunosorbent assay (ELISA) was used to detect the patients’ brain-derived neurotrophic factor (BDNF). Results:After treatment， the FMA， mBI score and BDNF were all higher than those before treatment (P<0.05). Compared with the control group， there was no statistically significant difference in the FMA， mBI score and BDNF in the treatment group (P>0.05) 30 days after treatment， while 60 days after treatment， the FMA， mBI score and BDNF were higher (P<0.05). By contrast， the HAMD score was negatively correlated with the BDNF expression and the HAMD scale score， and the correlation coefficient of Pearson was-0.949， P=0.000<0.05. Conclusion:Danzhi Tongzhu can significantly improve PSD symptoms of depression， and therefore further assist patients with recovery of body function， and the effect may be related to the increase in BDNF.

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