Clinical Research On Wuling Capsule Combined With Escitalopram Oxalate In The Treatment Of Post-stroke Sleep Disorder

Objective To compare the degree of anxiety,depression,fatigue and quality of life in acute ischemic stroke patients with sleep disorder and without sleep disorders;to analyze the correlation between sleep quality and the quality of life in acute ischemic stroke patients with sleep disorder.To observe the therapeutic efficacy of Wuling capsule combined with escitalopram oxalate in treating acute ischemic stroke patients with sleep disorder and the effect of combined therapy on the degree of anxiety,depression,fatigue and quality of life of ischemic stroke patients.Methods 1.103 patients with acute ischemic stroke(within 2 weeks)hospitalized in Wuhan General Hospital of Guangzhou Military Area Command of Chinese PLA.from June 2016 to February 2017 were recruited,according to the Pittsburgh sleep quality index scale(PSQI)they were divided into two groups,64 patients PSQI score greater than 7 as the sleep disorder group,39 patients of PSQI<7as a non sleep disorder group,collecting their demographic data and clinical data.Each of the two groups were measured with the National Institutes of Health Stroke Scale,Hamilton Anxiety Scale,Hamilton Depression Scale,Fatigue Severity Scale and strokespecific quality of life scale,Compare the differences of each scale of the two groups,analyze the correlation between sleep quality and quality of life with Multiple stepwise regression in patients with sleep disorders after stroke.2.64 post stroke sleep disorder patients were randomly divided into two groups: the control group(n = 31)and the study group(n =33),all patients were given routine ischemic stroke drug treatment,the control group were given escitalopram oxalate(oral 10mg/ day,of late),the study group were given Wuling capsule(oral 0.99 g 3times / day)and escitalopram oxalate(oral 10 mg once a day).Two groups of patients were Respectively measured with Pittsburgh sleep quality index scale,Hamilton Anxiety Scale,Hamilton Depression Scale,Fatigue Severity Scale and Stroke Specific Quality of Life Scale before and after treatment for 2 weeks,and 4weeks,compare the differences of two groups.Observing and comparing the efficacy of Wuling capsule combined with escitalopram oxalate in the treatment of post-stroke sleep disorder,and record their adverse effect.Results 1.103 cases of sleep disorders in patients with acute ischemic stroke group 64 cases,39 cases of non sleep disorder group,sleep disorders patients with PSQI score,NHISS score,Hamilton Anxiety Scale score,Hamilton Depression Scale score,Fatigue Severity Scale and Stroke Specific Quality of Life Scale compared with the non sleep disorder group had significant difference(P<0.05).There were 5 cases of mild sleep disorder in the 64 patients with post-stroke sleep disorder,moderate sleep disturbance in 50 cases and severe sleep disorder in 9cases.Multiple stepwise regression analysis on the quality of sleepand quality of life in post stroke sleep disorder patients showed that sleep efficiency and sleep time were positively correlated with quality of life,the impact of sleep efficiency on stroke patients' quality of life is significant.2.64 cases of sleep disorders after stroke were randomly divided into 2 groups,31 cases in the control group,the study group of33 cases.There was no significant difference in age?sex ?NHISS score and PSQI score in two groups(P>0.05),they were comparable.(1)Pittsburgh sleep quality index :Compared with the study group and the control group of two groups of patients after treatment for 2weeks,4 weeks before treatment PSQI score and PSQI score had significant difference(P<0.01);PSQI of the study group after treatment was 2 weeks,4 weeks and PSQI score of the control group after treatment for 2 weeks,4 weeks compared with the score significant difference(P<0.05).(2)Hamilton Anxiety Scale,Hamilton Depression Scale :Compared to the study group and the control group after treatment for 2 weeks,4 weeks of HAMA score and HAMD score before treatment with the HAMA scale and HAMD scale scores have significant difference(P<0.01);the study group after treatment of HAMA scale and HAMD were 2 and 4 weeks of the score with the control group after treatment 2 weeks,4 weeks of HAMA scale and HAMD scale score difference was statistically significant(P<0.01).(3)Fatigue Severity Scale:after treatment,the study group had significant difference in FSS scale score compared with before treatment(P<0.01);there was no significant difference before and after treatment in the control group(P>0.05);there was no significant difference between the study group and the control group in the FSS scale score after 2 weeks of treatment(P>0.05),after 4 weeks of treatment,the study group compared with the control group FSS scale score was significantly(P<0.05).(4)Stroke Specific Quality of Life Scale:the study group and the control group after each treatment period compared with before treatment,the difference was statistically significant(P<0.01);the SS-QOF scores of the study group after treatment were significantly different compared with the control group(P<0.05).Conclusion 1.Patients with sleep disorders after acute ischemic stroke were more likely to have a higher degree of neurologic impairment than those without sleep complaints,post-stroke sleep disorder patients had more serious anxiety,depression,higher levels of fatigue and poorer quality of life;in the treatment of stroke patients with active drug therapy and rehabilitation training should also pay attention to the sleep problems of stroke patients,early intervention should be performed in patients with sleep disorder,handling their negative emotions positively to improve their quality of life.2.Both Wuling capsule combined with escitalopram oxalate and escitalopram oxalate alone could improve sleep disorders in patients with stroke,the effect of Wuling capsule combined with escitalopram oxalate in the treatment of post stroke sleep disorder was better than single escitalopram oxalate.Wuling capsule can improve sleep and relieve fatigue in patients with stroke,escitalopram oxalate could improve stroke patients' anxity and depression,compared with escitalopram oxalate,two drugs combination could better improve the quality of life of stroke patients in the short term.