黄连温胆汤加味治疗卒中后抑郁症的效果及对脑神经代谢物表达水平的影响

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Abstract Objective To explore the clinical efficacy of Modified Huanglian Wendan Decoction in treating post-stroke depression (PSD) and its effect on the changes of brain neurometabolites in patients. Methods A total of 96 patients with PSD admitted to Tangshan Hospital of Traditional Chinese Medicine from June 2017 to December 2018 were selected and randomly divided into the observation group and the control group according to random number table method, 48 cases in each group. The control group was treated with Sertraline Hydrochloride Tablets orally, and the observation group was added with Modified Huanglian Wendan Decoction on the basis of the control group. All patients were treated for 8 weeks. The clinical efficacy of the two groups was compared. The depression symptoms [17 Hamilton depression scale (HAMD), Zung self-rating depression scale (SDS)], cognitive function [minimum mental state examination (MMSE)], the quality of sleep [Pittsburgh sleep quality index (PSQI)], daily living ability[improved Barthel index (MBI)] in the two groups were evaluated once before and after treatment. At the same time, the levels of brain neurometabolism indexs [norepinephrine (NE), dopamine (DA), the ratio of 5-hydroxytryptophan (5-HT) to 5-hydroxyindoleacetic acid (5-HIAA) (5-HT/5-HIAA ratio), and the ratio of 3,4-dihydroxyphenylacetic acid (DOPAC) to high vanillic acid (HVA) (DOPAC/HVA ratio)] were measured. Results The total effective rate of the observation group was significantly higher than that of the control group (P ＜ 0.05). Compared with before treatment, the scores of HAMD, SDS and PSQI were significantly lower, while the scores of MMSE and MBI were significantly increased (all P ＜ 0.05). Compared with the control group, the improvement was more obvious in the observation group (P ＜ 0.05). The concentrations of serum NE, DA and the ratios of 5-HT/5-HIAA and DOPAC/HVA were significantly higher in the two groups after treatment (all P ＜ 0.05). Compared with the control group, the improvement was more obvious in the observation group ( P ＜ 0.05). Conclusion The overall efficacy of Modified Huanglian Wendan Decoction in treating PSD is effective, which is helpful to relieve depressive symptoms, improve cognitive function and sleep quality of patients, which may be related to the significant positive regulation of the expression level of relevant cerebral nerve metabolites by this clinical experience prescription.

Key words： Post-stroke depression Modified Huanglian Wendan Decoction Cognitive function Sleep quality

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	WANG Yajuan LIU Yujie DUAN Hongli ZHANG Juan

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WANG Yajuan LIU Yujie DUAN Hongli ZHANG Juan. Effect of Modified Huanglian Wendan Decoction on post-stroke depression and its influence on the expression level of neurometabolites in brain[J]. 中国医药导报, 2019, 16(32): 75-78,94.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I32/75

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