| Objective: The purpose of this study was to observe the clinical efficacy of duloxetine combined with shugan anshen decoction in the treatment of moderate and severe post-stroke depression with liver-qi stagnation type compared with duloxetine alone.The changes of serum 5-HT and NE levels were observed and the mechanism was discussed.Methods:Select the first affiliated hospital of anhui medical university encephalopathy division between December 2017 and December 2018,qi of outpatient and inpatient ward in patients with liver within 60 cases of depression after stroke,USES the principle of random grouping is divided into observation group and control group 30 cases,observation group to conventional treatment + liver anshen decoction + duloxetine,the control group conventional treatment + duloxetine,respectively before and after treatment of 4 weeks,8 weeks and 2 weeks after the drug was stopped,Observe the Hamilton depression rating scale(HAMD),geriatric depression scale(GDS),TCM syndrome integral scale(diseases with ease),social function defect screening scale(SDSS),Pittsburgh sleep quality index scale(PSQI)score and serum 5-HT,NE level change,using SASS 21.0 data analysis concluded that observe the clinical efficacy and 5-HT,NE level change mechanism.Results: Before treatment,there was no significant difference in age,gender,nature of stroke,degree of depression,course of disease,and concomitant diseases between the two groups(P > 0.05),which was comparable.(1)the two groups of patients with depression degree efficacy: 4 weeks of treatment,8 weeks and 2 weeks after withdrawal of the two groups and before treatment,the scores were decreased,the difference was statistically significant(P<0.05).The differences between the treatment group and the control group at 4 weeks,8 weeks and 2 weeks after withdrawal were also statistically significant(P<0.05).The effective rate in the treatment group was 88.89%,and that in the control group was 78.57%,with statistically significant difference(P<0.05).Therefore,the effect of improving depression in the treatment group was higher than that in the control group.(2)comparison of overall efficacy of TCM syndrome points between the two groups: effective treatment group(92.59%),> control group(71.43%).Z=2.910,P=0.001,and the difference was statistically significant(P<0.05).The treatment group was higher than the control group.(3)comparison of GDSS,SDSS and PSQI between the two groups: the improvement degree of the treatment group was higher than that of the control group(P<0.05),indicating that the treatment group was better than the control group in improving depression,promoting the recovery of neurological function defects and stable sleep.(4)comparison of serum 5-ht and NE levels between the two groups: after treatment,serum 5-ht and NE levels in the two groups were higher than before,P<0.05 in the treatment group and the control group before and after treatment,and the difference was statistically significant.After treatment,serum 5-ht and NE levels in the treatment group were higher than those in the control group,and the difference was statistically significant(P<0.05),indicating that the serum 5-ht and NE levels in the treatment group were higher than those in the control group.(5)safety: the removal of cases in the treatment group of 1 case of Chinese medicine cannot tolerate patients and 1 case of duloxetine adverse reaction patients,the remaining two groups of patients before and after the treatment of vital signs,liver and kidney function,three routine(blood,urine,stool routine)and electrocardiogram did not appear abnormal.During the study,there were no adverse reactions and emergencies that needed to be dealt with.Conclusion: Shugan anshen decoction is effective in improving depression,syndrome,nerve defect and sleep stability after stroke.In addition,serum 5-ht and NE levels can be significantly increased with a long duration and high safety,which is worthy of clinical promotion and application. |
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