| Objective:Evaluate the clinical therapeutic effect on post-stroke depression kidney deficiency and live stagnation the syndrome of Peiyuan Kaiyu Decoction and explore its possible mechanism.Methods: 70 cases of patients in accordance with the random number table,were divided into observation group and control group,35 in each group.The control group supplements with Aspirin Enteric-coated Tablets(once every night,100mg),Atorvastatin Calcium Tablets(once every night,20mg),Citalopram Hydrobromide Tablets(once a day in the morning,40mg).And the observation group added with Peiyuan Kaiyu Decoction,twice a day,one packet every time.The treatment of two groups were 42 days.TCM syndrome grade HAMD NIHSS and ADL were examined before the treatment,and at the end of treatment.TCM syndrome grade,CRP and HCY were also made for two groups at the beginning and at the end of treatment.Results:(1)66 patients completed clinical trials,according to the program with 2 cases of self-releasing,1 case were loss to follow-up,1 case during treatment in conjunction with the outer court clinic application other antidepressants,33 cases in each group actually.There’s no sex,age,grades of TCM syndrome,scores of HAMD NIHSS and ADL and CRP,HCY difference between groups,which keeps a good balance(P(29)05.0).(2)Comparison of TCM syndrome grades before and after treatment: grades of the two groups were decreased compared with those before treatment by the analysis of repeated measures define factors,there was significance with P(27)05.0Comparison of TCM syndrome grades before and after treatment between two groups:grades of the two groups were decreased compared with those before treatment.By the paired samples t test,there was significance with P(27)05.0.It shows that the two groups after treatment of TCM syndrome study both had an improved;After the treatment,observation of TCM syndrome integral decreased significantly compared with controls,by the independent sample t-test,t =-2.733,P = 0.008,significant difference,that observation group of TCM syndrome study improved better than the control group.(3)Comparison of scores of HAMD before and after treatment between the groups:Scores of both of groups decreased compared with those before treatment by time By the paired samples t test,there was significance with P(27)05.0.It shows that the two groups after treatment the depression syndrome both had an improved.After the treatment,observation group and control group comparison HAMD scores decreased significantly,the independent sample t-test,t =-2.459,P = 0.017 significant difference,prompt observation group of depression symptoms improved better than that of control group.(4)Comparison of score of NIHSS before and after treatment between the groups:Scores of both of groups decreased compared with those before treatment by time flow.By the paired samples t test,there was significance with P(27)05.0.It shows that the two groups after treatment the Neurologic deficits syndrome both had an improved.After the treatment,observation group and the control group decreased significantly than the NIHSS score,by the independent sample t-test,t =-2.215,P = 0.003,significant difference,the function recovery of nerve defect that observation group is better than the control group.(5)Comparison of score of ADL before and after treatment between the groups:Scores of both of groups increased compared with those before treatment by time flow.By the analysis of repeated measures define factors,there was significance with paired samples t test,there was significance with P(27)05.0,it suggest two sets of daily life ability were improved after treatment;After the treatment,observation group and the control group than the ADL scores increased obviously,the independent sample t-test,t = 3.275,P = 0.02 significant difference,the ability to improve everyday life that observation group was better than control group.(6)Comparison of the contains of CRP and HCY before and after treatment between the groups:The two groups before and after treatment serum CRP levels are reduced,by the paired samples t test,it showed a significant difference(P < 0.05),suggesting there is a decrease in the degree of inflammation are the two groups after treatment;After the treatment,observation group and control group to compare the serum CRP levels drop significantly,by the independent sample t-test,t =-2.004,P = 0.049,significant difference,decreased inflammation that observation group was better than the control group.The two groups before and after treatment serum HCY levels were decreased,by the paired samples t test,it showed a significant difference(P < 0.05),suggesting the two groups after treatment of HCY levels are falling;After the treatment,observation group and control group to compare serum HCY levels drop significantly,the independent sample t-test,t =-2.474,P = 0.016,significant difference,prompt treatment group HCY reduce degree is better than the control group.(7)Comparison of two groups of curative effect of TCM syndrome integral: the control group 33 cases,clinical recovery in 1 case,3%;17 cases were markedly improved(52%),effective 8 cases(24%),invalid 7 cases,accounting for 21%.Observation group of 33 cases,clinical recovery in 2 case,6%;16 cases were markedly improved(49%),effective 12 cases(36%),invalid 3 cases,accounting for 9%.The Mann-Whitney U rank and inspection,05.2695.4021TT(28)(28),,Z = 2.813,P = 0.005,according to the standard ?(28)5.0,level of two groups of TCM syndrome study curative effect of significant difference,prompt curative effect observation group is better than the control group.(8)Comparison of two groups of HAMD score curative effect : the control group 33 cases,2 cases had marked effect,6%;effective 22 cases(67%),invalid 6 cases(18%),and deterioration in 3 cases(9%).Observation group of 33 cases,3 cases had marked effect,10%;effective 25 cases(75%),invalid 4 cases,accounting for 12%;deterioration in 1 case.The Mann-Whitney U rank and inspection,36.2564.4121TT(28)(28),,Z = 3.583,P < 0.001,according to the standard?(28)5.0,two groups of HAMD score changes have significant curative effect level,prompt the degree of depression treatment group to improve curative effect is better than the control group.Conclusion: 1 We can see that Peiyuan Kaiyu Decoction in the therapy of PSD kidney deficiency and liver stagnation has an obvious therapeutic effect,by the following aspects,improve the performance of traditional Chinese medicine syndrome,improve patients with depressive symptoms,improve nerve function defect,and improve the ability of patients daily life,its mechanism may be associated with inflammation of antagonism,HCY resistance.2 The therapeutic effect of Peiyuan Kaiyu Decoction is reliable and safe with no bad reaction. |
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