解郁通络方对脑卒中后抑郁神经免疫炎症指标的影响

李庆丽; 王贵贤; 王艳捷; 杨明

doi:10.13422/j.cnki.syfjx.20180625

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解郁通络方对脑卒中后抑郁神经免疫炎症指标的影响

临床 | 更新时间：2024-01-04

- 解郁通络方对脑卒中后抑郁神经免疫炎症指标的影响
- Effect of Jieyu Tongluo Decoction on Neuroimmune Inflammatory Markers of Depression After Ischemic Stroke
- 中国实验方剂学杂志 2018年24卷第6期页码：204-209
- 作者机构：
- 作者简介：
- 基金信息：
  
  河南省教育厅重点科学技术项目（16B320222）
- DOI：10.13422/j.cnki.syfjx.20180625
  中图分类号： R277.7
- 纸质出版日期：2018
- 稿件说明：
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李庆丽, 王贵贤, 王艳捷, 等. 解郁通络方对脑卒中后抑郁神经免疫炎症指标的影响[J]. 中国实验方剂学杂志, 2018,24(6):204-209.

LI Qing-li, WANG Gui-xian, WANG Yan-jie, et al. Effect of Jieyu Tongluo Decoction on Neuroimmune Inflammatory Markers of Depression After Ischemic Stroke[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(6): 204-209.
李庆丽, 王贵贤, 王艳捷, 等. 解郁通络方对脑卒中后抑郁神经免疫炎症指标的影响[J]. 中国实验方剂学杂志, 2018,24(6):204-209. DOI： 10.13422/j.cnki.syfjx.20180625.

LI Qing-li, WANG Gui-xian, WANG Yan-jie, et al. Effect of Jieyu Tongluo Decoction on Neuroimmune Inflammatory Markers of Depression After Ischemic Stroke[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(6): 204-209. DOI： 10.13422/j.cnki.syfjx.20180625.

摘要

目的：探讨解郁通络方对脑卒中后抑郁症的临床疗效及对神经免疫炎症若干指标的影响。方法：选自缺血性脑卒中后抑郁症住院患者112例，采用入院先后顺序，随机按数字表法分为观察组和对照组各56例。两组患者均参照《中国脑卒中康复治疗指南》给予常规干预。对照组口服盐酸帕罗西汀片，初始剂量为20 mg ·d-1，依病情逐渐以每周增加10 mg，最大剂量≤ 40 mg ·d-1。观察组在对照组治疗的基础上加服解郁通络方，1剂/d。两组疗程均连续治疗6周。比较两组患者抑郁自评量表（SDS），HAMD量表因子积分及临床疗效。检测两组血清中白细胞介素（IL）-1β，IL-2，IL-6和肿瘤坏死因子-α（TNF-α）水平，血浆中促肾上腺皮质激素释放激素（CRH），促肾上腺皮质激素（ACTH）和皮质醇（Cor）及T淋巴细胞亚群CD3+，CD4+，CD8+水平。结果：治疗3周和6周后，观察组患者的SDS评分分别低于对照组同时点（P<0.01）。观察组治疗后HAMD量表各因子评分明显少于对照组（P<0.01）。观察组患者总有效率为88.89%，明显高于对照组的71.7%（P<0.05）。治疗后，观察组患者血清中IL-1β，IL-2，IL-6和TNF-α水平及血浆中CRH，ACTH和Cor水平均明显低于对照组（P<0.01）。观察组治疗后CD3+，CD4+均显著高于对照组，CD8+明显低于对照组（P<0.01）。结论：解郁通络方治疗脑卒中后抑郁症有明显的疗效，可降低炎性因子的释放，调节下丘脑-垂体-肾上腺轴（HPA）作用，增强细胞免疫功能，从而发挥改善脑卒中后抑郁症的效果。

Abstract

Objective: To investigate efficacy of Jieyu Tongluo decoction in treating depression after ischemic stroke and its influence on neuroimmune inflammatory markers.Method: One hundred and twelve cases with depression after ischemic stroke were elected and randomly divided into observation group (56 cases) and control group (56 cases) by referring to random number table.Both groups received conventional intervention by referring to ‘Chinese stroke rehabilitation treatment guidelines’.Cases of control group were orally given with paroxetine hydrochloride

20 mg/day at beginning

10 mg increasing per week

and maximum dose ≤ 40 mg/day.On basis of control group

observation group was given with Jieyu Tongluo decoction

1 dose/day.Two groups were observed for 6 weeks.Scores of depression self rating scale(SDS)

HAMD factors

and efficacy were compared in both groups.Serum levels of interleukin(IL) -1β

IL-2

IL-6 and tumor necrosis factor(TNF) -α

plasma levels of corticosteroid release hormone(CRH)

corticosteroid (ACTH) and cortisol(Cor) and levels of CD3+

CD4+

CD8+ were detected in two groups.Result: After 3 weeks and 6 weeks treatment

SDS score of observation group was lower than that of control group(P<0.01).HAMD factors scores of observation group were lower than those of control group after treatment(P<0.01).Total effective of observation group was 88.89%

which was evidently higher than 71.7% of control group (P<0.05).After treatment

serum levels of IL-1β

IL-2

IL-6 and TNF-α and plasma levels of CRH

ACTH and Cor of control group were remarkably lower than those of control group (P<0.01).After treatment CD3+ and CD4+ of observation group were obviously higher

while CD8+ was lower

than control group(P<0.01).Conclusion: Efficacy of Jieyu Tongluo decoction in treating depression after ischemic stroke is significant and may improve depression after ischemic stroke through inhibiting inflammatory factor index level

regulation of hypothalamic-pituitary-adrenal axis(HPA) function

and increase cellular immune function.

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