Efficacy Of Citalopram Combined With Hyperbaric Oxygen In Post-stroke Depression

Objective:To explore the effect and mechanism of citalopram combined with hyperbaric oxygen in the treatment of post-stroke depression(PSD),and to provide guidance for clinical treatment of PSD.Methods:We selected 120 cases of PSD patients treated in the Department of Neurology of a University From February 2018 to February 2020.Seven of the quit,eventually 113 people took part in the experiment.All of selected PSD patients were randomly treated with conventional neurology,rehabilitation and psychotherapy with the permission of their family.Our sample were randomly divided into 4 groups,for group A who was given conventional medical treatment,psychological treatment and rehabilitation exercise,for group B who was received with citalopram antidepressant therapy on the basis of group A,for C group who was treated with hyperbaric oxygen based on group A,for D group who was received with citalopram antidepressant therapy and hyperbaric oxygen combination therapy on the basis of group A.All four groups of patients were treated with symptomatic conventional treatment,which including symptomatic supportive treatment for improving brain microcirculation,nutritional nerves,anticoagulation,dehydration,and anti-free radicals,rehabilitation and psychological treatment of stroke.The patients with hypertension,diabetes and other related diseases are provided withhypoglycemic and antihypertensive.Psychotherapy is routine psychological counseling for patients to relax them,including listening to music and communication with their family members.The ues of citalopram(starting amount was 10 mg / time,once / day,there was no obvious adverse reaction after 1 week of application,the dosage was increased to 20 mg / time,once / d for 4 weeks).Group C was treated with hyperbaric oxygen on the basis of group A after the diagnosis,with a pressure of 0.12 MPa,90 min / times,5 times a week,and continued treatment for 4 weeks.We examine the changes of depressive symptoms,neurological function,ability of daily living,quality of life,blood viscosity and serum inflammatory factors(HMG-B1,IL-8,TNF-a)levels and adverse reactions for four groups during the pre-or post-event period for.Results:1.There were no significant differences in baseline indexes among the four groups before treatment,such as gender,age,PSD occurrence time,stroke site,whether surgery,and combined symptoms(P>0.05).2.There were no significant in SDS and HAMD scores in the four groups before treatment(P>0.05),SDS and HAMD scores in the four group decreased after treatment,the difference before and after treatment was statistically significant in each group(p<0.01).3.There were no significant in NIHSS、Mo CA、ADL scores in thefour groups before treatment(P>0.05),MoCA and ADL scores in the four group declined after treatment,NIHSS scores in the four group decreased after treatment,the difference before and after treatment was statistically significant in each group(p<0.01).4.There were no significant in The post-treatment comprehensive quality of life questionnaire(GQLI-74)scores in the four groups before treatment(P>0.05),after treatment,the scores of each dimension in four groups increased to different degrees,the difference before and after treatment was statistically significant in each group(p<0.01).5.There were no significant in the FIB,PV,qb,and ERI of the A,B,C,and D before treatment(P>0.05),the hemorheology indexs of the four group decreased after treatment,the difference before and after treatment was statistically significant in each group(p<0.01).6.There were no significant in the HMG-B1,IL-8,and TNF-a of the A,B,C,and D before treatment(P>0.05),Serum levels of HMG-B1,IL-8,and TNF-a decreased after treatment in groups A,B,C,and D,the difference before and after treatment was statistically significant in each group(p<0.01).7.There were no significant adverse reactions in group A,B,C and D after four weeks of medication(p>0.05).Conclusion:Citalopram combined with hyperbaric oxygen can effectivelyimprove the clinical symptoms of patients with PSD,reduce depression,improve cognitive function and daily living ability of patients,and improve the quality of life of patients.It is superior to monotherapy and hyperbaric oxygen therapy without significant adverse effects.Moreover,its treatment mechanism may be related to citalopram combined with hyperbaric oxygen can improve blood viscosity and reduce serum inflammatory factor levels in patients with PSD.