摘要
目的 分析柴胡疏肝散加减联合经颅电刺激对脑卒中后抑郁病人5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)水平的影响。方法 选取2019年4月—2020年5月在我院就诊的脑卒中后抑郁病人250例,按照随机数字分配法分为经颅电刺激治疗组和联合治疗组,各125例。经颅电刺激治疗组在常规治疗的基础上给予经颅电刺激治疗,联合治疗组在经颅电刺激治疗组的基础上给予柴胡疏肝散加减治疗。采用ED723高效液相色谱电化学检测器检测5-HT水平,采用酶联免疫吸附法检测BDNF水平,应用汉密尔顿抑郁量表(HAMD)评估病人的抑郁程度,应用汉密尔顿焦虑量表(HAMA)评估病人的焦虑程度,应用手臂动作调查测试表(ARAT)评估病人上肢运动功能恢复情况,应用改良Barthel指数(MBI)评估病人日常生活活动能力,应用洛文斯顿认知评定量表(LOTCA)评估病人的认知功能状态。统计两组临床疗效总有效率和并发症总发生率。结果 治疗后,两组5-HT、BDNF水平、ARAT、MBI、LOTCA评分均高于本组治疗前,HAMD、HAMA评分均低于本组治疗前;且联合治疗组5-HT、BDNF水平、ARAT、MBI、LOTCA评分均高于经颅电刺激治疗组,HAMD、HAMA评分均低于经颅电刺激治疗组,差异均有统计学意义(P<0.05)。联合治疗组临床疗效总有效率高于经颅电刺激治疗组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论 柴胡疏肝散加减联合经颅电刺激对脑卒中后抑郁的治疗效果较好,可提高病人5-HT、BDNF水平,减轻病人抑郁、焦虑程度,增强上肢运动能力,提高认知功能。
Objective To explore the effect of modified Bupleurum Liver-coursing Powder combined with transcranial electrical stimulation on the levels of 5-hydroxytryptamine(5-HT)and brain-derived neurotrophic factor(BDNF)in patients with post-stroke depression.Methods From April 2019 to May 2020,250 patients with stroke depression were selected and divided into transcranial electrical stimulation group and combined treatment group according to random digital distribution method,with 125 patients in each group.The patients in transcranial electrical stimulation group were given transcranial electrical stimulation,and the patients in combined treatment group were given modified Bupleurum Liver-coursing Powder on the basis of transcranial electrical stimulation treatment group.The level of 5-HT was detected by ED723 electrochemical detector.The level of BDNF was detected by enzyme-linked immunosorbent assay.The degree of depression was assessed by Hamilton Depression Scale(HAMD),and the degree of anxiety was assessed by Hamilton Anxiety Scale(HAMA).Action Research Arm Test(ARAT)was used to assess the recovery of upper limb motor function.Modified Barthel index(MBI)was used to assess the activities of daily life.Loewenstein Occupational Therapy Cognitive Assessment(LOTCA)was used to assess the patients′cognitive status.The total effective rate of clinical efficacy and total complication rate were calculated.Results After treatment,5-HT level,BDNF level,ARAT score,MBI score,and LOTCA score of two groups were higher than those before treatment,and 5-HT level,BDNF level,ARAT score,MBI score,and LOTCA score of combined treatment group were higher than those of transcranial electrical stimulation group.The total effective rate of combined treatment group was higher than that of transcranial electrical stimulation group(P<0.05).There was no significant difference in the incidence of adverse reactions between two groups.Conclusion Modified Bupleurum Liver-coursing Powder combined with transcranial electrical stimulation possesses better therapeutic effect on post-stroke depression,which can improve the levels of 5-HT and BDNF,reduce the degree of depression and anxiety,enhance the motor ability of upper limbs,and improve the cognitive function of patients.
作者
李倩
刘秀红
LI Qian;LIU Xiuhong(Dezhou Hospital of Traditional Chinese Medicine,Dezhou 250300,Shandong,China)
出处
《中西医结合心脑血管病杂志》
2022年第10期1755-1759,共5页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
山东省中医药科技发展计划项目(No.2019-0866)。
关键词
脑卒中后抑郁
柴胡疏肝散加减
经颅电刺激
5-羟色胺
脑源性神经营养因子
post-stroke depression
modified Bupleurum Liver-coursing Powder
transcranial electrical stimulation
5-hydroxytryptamine
brain-derived neurotrophic factor
