The Clinical Effect On The Treatment Of Yin Deficiency And Blood Stasis Type Post-stroke Depression(Mild To Moderate)by Regulating Spirit And Body

Objective:Based on the pathogenesis essence of Yin deficiency of the liver and kidney in the convalescent period of apoplexy and the academic thought of "regulating spirit as the first thing in medical treatment" in Lingshu · Benshen,the method of regulating spirit and body was formed.In this study,five elements music was used to regulate the spirit,and oral Chinese medicine was used to regulate the body.To observe the clinical effect of Modified Baihe Dihuang Decoction combined with "Wuyin Tiaoshen" technology in the treatment of Yin deficiency and blood stasis type post-stroke depression(mild to moderate).Methods:From April 2021 to December 2022,70 patients meeting the inclusion criteria were collected and divided into treatment group and control group by random number table method,with 35 cases in each group.The treatment group was treated with modified Baihe Dihuang Decoction combined with "Wuyin Tiaoshen" technology,and the control group was treated with Sertraline hydrochloride tablets,the treatment cycle was 4weeks.The changes of Hamilton Depression Scale 17(HAMD-17),Self-rating Depression Scale(SDS),Fugl-Meyer Assessment(FMA)and Pittsburgh Sleep Quality Index(PSQI)and TCM symptom score before and after treatment were observed in two groups,and serum 5-hydroxytryptamine(5-HT)levels were detected before and after treatment.Results:(1)A total of 66 patients completed the study,including 33 in the treatment group and 33 in the control group.There were no significant differences in gender,disease type,age and course of disease between 2 groups(P>0.05).(2)HAMD-17 scores and SDS scores: Intra-group comparison: HAMD-17 scores and SDS scores were decreased in both groups after treatment(P<0.05).Intra-group comparison: HAMD-17 and SDS scores decreased in both groups after treatment(P<0.05).Comparison between groups: After 4weeks of treatment,HAMD-17 scores and SDS scores in the treatment group were significantly lower than those in the control group.The results indicated that depression status was improved in both groups,and the improvement was more obvious in the treatment group.(3)HAMD-17 factor score: Intra-group comparison: After treatment,there were improvements in anxiety/somatization,block,sleep disturbance,and cognition in both groups(P<0.05),but there was no statistical significance in weight change in both groups(P>0.05).(4)FMA score: Intra-group comparison: FMA score was increased in both groups after treatment(P<0.05).Comparison between groups: After 4 weeks of treatment,the FMA score in the treatment group was significantly higher than that in the control group(P<0.05).The results indicated that motor function was improved in both groups,and the improvement was more obvious in the treatment group.(5)PSQI score:Intra-group comparison: PSQI score was decreased in both groups after treatment(P<0.05).Comparison between groups: After 4 weeks of treatment,the PSQI score in the treatment group was significantly lower than that in the control group(P<0.05).The results indicated that sleep quality was improved in both groups,and the improvement was more obvious in the treatment group.(6)TCM syndrome score: Intra-group comparison:the scores of TCM syndrome in the treatment group were significantly improved after treatment compared with before treatment(P<0.05);In the control group,only depression,reduced interest,anxiety,insomnia,and dreams were improved(P<0.05),but there was no statistical significance in improving fatigue,waist and knee weakness,constipation(P>0.05).Comparison between groups: After 4 weeks of treatment,compared with the control group,the treatment group significantly improved in insomnia,dreaminess,fatigue,waist and knee tenderness,and constipation(P<0.05).(7)Serum 5-HT: Intra-group comparison: Serum 5-HT was increased in both groups after treatment(P<0.05).Comparison between groups: After 4 weeks of treatment,serum 5-HT in the treatment group was higher than that in the control group(P<0.05).(8)The overall effective rate of the treatment group was 88.88% higher than that of the control group(P<0.05).(9)Safety evaluation: No adverse reactions occurred in 66 patients during the study period,and no obvious abnormalities were found in safety indicators.Conclusion: Modified Baihe Dihuang Decoction combined with "Wuyin Tiaoshen" technology has significant curative effect in the treatment of patients with PSD,which is superior to western medicine Sertraline in improving patients’ depression,physical movement ability,sleep quality and TCM symptomes.The mechanism of action may be related to the increase of serum 5-HT level.