The Clinical Research Of Strategy Shuganliqi On Poststroke Depression、cognitive Function And Neurological Function

Research background:Stroke is one of three disease which result in the deaths of human beings,with the characteristics of high incidence,high morbidity,high mortality rate,high recurrence rate,and high economic burden.There are many clinical complications after stroke,among which depression and cognitive impairment are the most important and common of stroke.But,in the clinical work,a lot of clinic workers tend to be neglect the issue about emotional disorders and cognitive dysfunction after stroke patients,they do not pay enough attention on the loss of these function.Poststroke depression and cognitive impairment had significant impact on the process of neurological rehabilitation,prolonged hospitalization and increased medical costs,ultimately,it may affect the patient’s quality of life,brought heavy burden for individuals,families and society.After cerebral apoplexy,affective disorder and cognitive dysfunction are often associated with each other,and the interaction between them is increasingly concerned by more and more clinical workers.Early intervention for post-stroke depression can make the patients with cognitive dysfunction have a certain degree of improvement in cognitive function,corresponding improving patients,nerve function,make the patient’s daily life and social intercourse ability get a recovery.Object:1.To observe the clinical effect of strategy Shuganliqi with traditional western medicine treatment on post-stroke depression.2.To observe the effect of positive intervention on cognitive function and neurological function of patients after stroke.3.To observe the effect of strategy Shuganliqi on the serum NSE level.Method:This topic were included outpatient and the inpatient stroke patients60 people in Chinese medicine hospitals of Guangzhou City in June 2016 to February 2018,and then,randomly divided them into treatment group(Chaihushugan powder+Sertraline+Donepezil Hydrochloride Tablets)30 cases and control group(Sertraline+Donepezil Hydrochloride Tablets)30 cases,Four weeks as a course of treatment.Evaluated the level of Hamilton Depression Scale(HAMD-24)、 Mini mental state examination(MMSE)、 NIH Stroke Scale(NIHSS)and Neuron specific enolase(NSE)before and after treatment,After 2 weeks of treatment,evaluated the changes of TCM syndromes and HAMD-24.The results were analyzed with SPSS17.0 system.Result:1.Comparison of TCM syndromes: Two groups of patients were significantly improved in TCM syndromes after 2 weeks and 4 weeks after treatment(P<0.01).After 4 weeks of treatment,compared with 2 weeks after treatment,the improvement of TCM syndromes was obvious(P<0.01).It indicates that both of the two treatment regimens could significantly improve the clinical symptoms of patients,but the treatment group was superior to the control group(P<0.05).There were significant differences between the two groups of patients after 2 weeks and 4 weeks treatment(P<0.01).2.Comparison of HAMD-24: The HAMD-24 score was lower in the treatment group after 2 weeks of treatment compared with before treatment(P<0.01)there is no change in the control group(P>0.05)HAMD-24 scores decreased significantly in both groups after 4 weeks of treatment(P<0.01).After 4 weeks of treatment,the HAMD score was significantly decreased with after 2 weeks of treatment(P<0.01).There was no significant difference in HAMD-24 scores between the two groups after 2weeks of treatment(P>0.05).The HAMD-24 score of treatment group was lower than the control group after 4 weeks of treatment(P<0.05).There was no difference in HAMD-24 reduction rate between the two groups after2 weeks of treatment(P>0.05),but significant after 4 weeks of treatment(P<0.01).3.Comparison of MMSE: After 4 weeks treatment,the MMSE score of treatment group significantly increase(P<0.01)and control group in MMSE score also increased(P<0.05),the MMSE score of treatment group is higher than the control group(P<0.05),the MMSE efficacy index of treatment group is better than that of control group(P<0.05).4.Comparison of NIHSS: After 4 weeks of treatment,the NIHSS score of the treatment group was significantly reduced(P<O.01),and the improvement of NIHSS score in the control group was not improved(P>0.05),and the NIHSS score in the treatment group was lower than that in the control group(P<0.05).5.NSE grading change comparison: After 4 weeks of treatment,the NSE of the treatment group was significantly reduced(P<0.01),and the NSE level of the control group was not changed(P>0.05),and the NSE level of the treatment group was significantly lower than that in the control group(P<0.01).Conclusion:1.Use strategy Shuganliqi combined with conventional Chinese medicine can significantly improved the depressive symptoms.2.Active intervention in post-stroke depression,emotional disorders can improve their cognitive function and neural function,affective disorder after stroke has a certain correlation between cognitive function and neural function,after stroke patients suffering from depression may increase their cognitive dysfunction and the degree of nerve function defect.3.Strategy Shuganliqi can improve the serum NSE level and promote the recovery of nerve function.