柴胡疏肝散治疗卒中后抑郁临床观察及对血浆5-HT的影响分析.pdfVIP

1 17 项汉密尔顿评分量表···········································································34 2 神经功能缺损评分量表································································································35 3 中医证候量表················································································································37 4 卒中后抑郁观察表········································································································.39 5 文献综述························································································································.41 中英文词语对照 中 文 英 文 英文缩写 卒中后抑郁 Post Stroke Depression PSD 柴胡疏肝散 Chai Hu Shu Gan San CHSGS 肝气郁结 Stagnation Of Liver Qi SOLQ 盐酸氟西汀胶囊 Fluoxetine Capsule FXTC 中医证候量表 Traditional Chinese Medicine TCMSS Symptoms and Signs Scale 斯堪的纳维亚卒中量表 Scandinavian Stroke Scale SSS 汉密尔顿抑郁量表 Hamilton Assess Depression Scale HAMD 五羟色胺 5-hydroxytryptamine 5-HT 摘要 摘 要 目的：观察柴胡疏肝散方对卒中后抑郁(PSD)肝气郁结型患者的临床治疗作 用，从中探讨中医治疗 PSD 的优势；通过测定血浆五羟色胺（5-HT ），探讨柴胡 疏肝散治疗 PSD 可能的作用机理，为研究中医药防治 PSD 提供借鉴。 方法：选取符合纳入标准的 PSD （肝气郁结型）患者60 例，按就诊先后顺 序随机分为：中药治疗组（柴胡疏肝散）30 例，对照组 30 例，采用单盲法观 察，两组患者均进行脑血管病的基础治疗及口服盐酸氟西汀胶囊（百忧解） 20mg/d 的抗抑郁治疗。在此基础上，治疗组加予柴胡疏肝散基本方治疗（柴胡 12g，枳壳 12g，白芍 30g，甘草 6g，香附 10g，陈皮 12g，川芎 12g，半夏 6g，石菖蒲 12g，郁金 10g），各种中药均为中药配方颗粒，每日 1 剂，分 2 次 水冲服，疗程 6 周。对治疗前，治疗 2 周、4 周、6 周的汉密尔顿抑郁量表(HAMD) 评分改变进行评定。对治疗前，治疗 6 周后的神经功能缺损量表（SSS）、中医 症候量表评分改变进行评定，观察临床疗效（量表评定由受过专业培训的医师 共同评定）。于治疗前与治疗 6 周后行肝肾功能检查，同时测定外周血浆五羟色 胺的水平，并对两组治疗后的不良反应进行监测，对柴胡疏肝散治