甜梦口服液联合帕罗西汀治疗缺血性中风后焦虑抑郁共病（肾虚证）的临床研究

发布时间：2018-03-29 19:50

本文选题：缺血性中风　切入点：焦虑抑郁共病　出处：《河南中医学院》2014年硕士论文

【摘要】：目的：本研究是在甜梦口服液既往临床应用和研究的基础上，通过观察患者汉密尔顿焦虑量表(14项HAMAl4)、汉密尔顿抑郁量表(17项HAMDl7）、神经功能缺损评分（NIHSS)、中医症候评分等指标的变化，来全面客观地评价甜梦口服液联合帕罗西汀治疗缺血性中风后焦虑抑郁共病（肾虚证）的临床疗效，为甜梦口服液在临床中进一步扩大应用奠定基础。方法：采取随机对照的设计方法，选取符合缺血性中风后焦虑抑郁共病（肾虚证）诊断标准，并且发病后无意识障碍、严重失语、构音障碍等影响临床评价的60例患者，采用随机数字表的方法随机分配为治疗组和对照组各30例，各组患者均在按2010版《中国脑血管病防治指南》给予标准二级预防基础上，治疗组给予甜梦口服液联合帕罗西汀，对照组给予帕罗西汀，疗程4周，甜梦口服液（每日2次，20ml/次），帕罗西汀（每日1次，，20mg/次）。在治疗前、治疗后分别对受试者进行汉密尔顿焦虑量表(14项HAMAl4)、汉密尔顿抑郁量表(17项HAMDl7)、神经功能缺损量表（NIHSS)评估以及中医症候评分,试验前、试验结束时分别检测ALT、AST、BUN、Cr，观察患者不良反应并及时进行记录。数据采用Spss17.0进行统计分析。结果：两组病人在性别、年龄、民族、文化程度、病程、伴随疾病等基线方面具备可比性（P0.05）。4个方面疗效指标结果如下： 1HAMA和HAMD量表积分：①治疗前两组HAMA和HAMD量表评分情况比较，统计学处理无显著性差异（P0.05）；②两组治疗前后组内比较，统计学处理（P0.05），有显著性差异，提示两组均能改善HAMA和HAMD量表积分；③治疗后两组组间比较，统计学处理有显著性差异（P0.05）提示甜梦口服液联合帕罗西汀能够更有效的改善HAMA和HAMD量表积分。 2中医症候积分：①治疗前两组中医症候积分组间比较，统计学处理无显著性差异（P0.05）；②治疗组治疗前后组内比较（P0.05），对照组治疗前后组内比较（P0.05）；③治疗后两组组间比较，统计学处理有显著性差异（P0.05），提示甜梦口服液能够有效的改善中医症候。 3神经功能缺损积分：①治疗前两组NIHSS量表积分比较，无显著性差异（P0.05)；②两组治疗前后组内比较，统计学处理（P0.05），有显著性差异，提示两组均能促进神经功能康复；③治疗后两组组间比较，统计学处理有显著性差异(P0.05)，提示甜梦口服液联合帕罗西汀能够更有效促进患者神经功能康复。 4治疗期间治疗组和对照组未见严重不良反应。结论：甜梦口服液联合帕罗西汀能够更有效的改善缺血性中风后焦虑抑郁共病患者的临床症状和中医肾虚证症候，促进神经功能的康复，临床用之安全有效。
[Abstract]:Objective: on the basis of previous clinical application and study of Tianmeng Oral liquid, the changes of 14 items of Hamilton anxiety scale (Hamilton anxiety scale), 17 items of Hamilton Depression scale (Hamilton Depression scale), 17 items of HAMDL 7s, neurological impairment score (NIH) and TCM symptom score (TCM) were observed. Objective to evaluate the clinical efficacy of Tianmeng oral liquid combined with paroxetine in the treatment of post-ischemic apoplectic anxiety and depression syndromes (kidney deficiency syndrome), and lay a foundation for the further application of Tianmeng oral liquid in clinical practice. Methods: a randomized controlled design was used to select 60 patients who met the diagnostic criteria of post-ischemic anxiety and depression syndromes (kidney deficiency syndrome), and who were affected by the clinical evaluation, such as unconscious disorder, severe aphasia, dysarthria and so on. The patients in each group were randomly assigned into treatment group (n = 30) and control group (n = 30). All patients in each group were treated with Tianmeng oral liquid combined with paroxetine on the basis of standard secondary prevention and treatment according to the 2010 edition of China guidelines for the Prevention and treatment of Cerebrovascular Disease. The control group was given paroxetine for 4 weeks, sweet dream oral liquid (20 ml / d) and paroxetine (20 mg / d). After treatment, 14 items of Hamilton anxiety scale (Hamilton anxiety scale), 17 items of Hamilton Depression scale (Hamd), 17 items of Hamilton Depression scale (Hamilton Depression scale) and NIHSSs were evaluated, and the scores of TCM symptoms were evaluated. At the end of the trial, the patients were detected for alt ASTX bun Cr3, and the adverse reactions were observed and recorded in time. The data were analyzed by Spss17.0. Results: the baseline of sex, age, nationality, education, course of disease and concomitant disease were comparable between the two groups (P < 0.05). The results were as follows:. Before the treatment of 1HAMA and HAMD, there was no significant difference in the scores of HAMA and HAMD between the two groups. There was no significant difference between the two groups before and after treatment, and there was a significant difference between the two groups before and after treatment, and there was significant difference between the two groups before and after treatment, and there was a significant difference between the two groups before and after treatment. It was suggested that both groups could improve the scores of HAMA and HAMD after treatment with HAMA and HAMD. There was a significant difference between the two groups (P 0.05). It suggested that Tianmeng Oral liquid combined with paroxetine could improve the scores of HAMA and HAMD more effectively. (2) there was no significant difference between the two groups before and after the treatment of TCM symptom integral. There was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups before and after treatment in the control group, and there was no significant difference between the two groups before and after treatment in the control group, and there was no significant difference between the two groups before and after treatment in the control group, and there was no significant difference between the two groups before and after treatment. Statistical analysis showed significant difference (P 0.05), suggesting that Tianmeng Oral liquid could effectively improve the symptoms of traditional Chinese Medicine (TCM). 3 there was no significant difference in the scores of NIHSS scale between the two groups before and after the treatment of neurologic impairment score: there was no significant difference. There was significant difference between the two groups before and after treatment, and there was a significant difference between the two groups before and after treatment (P 0.05), and there was a significant difference between the two groups before and after treatment. It was suggested that the two groups could promote the rehabilitation of nerve function. There was a significant difference between the two groups after treatment. It suggested that the combination of Tianmeng oral liquid and paroxetine could promote the recovery of nerve function of the patients more effectively. 4 there were no serious adverse reactions in the treatment group and the control group during the treatment period. Conclusion: the combination of Tianmeng oral liquid and paroxetine can effectively improve the clinical symptoms and kidney deficiency syndrome of patients with post-ischemic apoplectic anxiety and depression syndromes, promote the recovery of nerve function, and be safe and effective in clinical use.
【学位授予单位】：河南中医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

【参考文献】