To Explore The Clinical Effect Of Fangji Dihuang Decoction On Post-stroke Depression Based On The Theory Of "Below The Kidney And Above The Brain"

Objective:Based on the theory of"below the kidney and above the brain",the clinical efficacy of Fangji Dihuang Decoction in the treatment of post-stroke depression caused by kidney-yin deficiency is provided,which provides a basis for the treatment of post-stroke depression with Chinese medicine.Methods:Using random number table method,78 patients who met the inclusion criteria of this trial were divided into control group and observation group,39 cases in each group.On the basis of standardized Western medicine diagnosis and treatment in both groups,the control group was given citalopram hydrobromide tablets,and the observation group was given citalopram hydrobromide tablets and Fangji Dihuang Decoction for 8 weeks.Observe the changes of TCM symptom scores,HAMD,NIHSS,and ADL scores before and after treatment in the two groups,and use the changes in TCM syndrome scores and HAMD scores for clinical efficacy assessment.Results:Among the 78 subjects,1 case was lost due to loss of follow-up in the control group,2 cases were eliminated due to self-stopping medication,and 1 case was eliminated due to the combination of other antidepressant drugs;2 cases were excluded due to the self-stopping medication in the observation group,2 cases were excluded due to the combination of other antidepressants.A total of 70 cases were actually observed,35 in the control group and 35 in the observation group.1.Baseline data comparison:There was no statistically significant difference in age,gender,education level,stroke location,previous history score,smoking,and alcohol consumption between the two groups(P>0.05)and was comparable.2.Comparison of observation indicators:2.1 Comparison of TCM syndrome points:There is no statistically significant difference between the two groups of TCM syndrome points before treatment(P>0.05).After treatment,the TCM syndrome scores of both groups decreased compared with before treatment.The difference between the groups was statistically significant(P<0.001);between groups,the TCM syndrome score of the observation group decreased more significantly,and the difference was statistically significant(P<0.001).2.2 Comparison of HAMD scores:There was no significant difference in HAMD scores between the two groups before treatment(P>0.05).After treatment,the HAMD scores of the two groups were lower than before treatment.The difference between the groups was statistically significant(P<0.001);compared between the groups,the HAMD score of the observation group decreased more significantly,and the difference was statistically significant(P<0.001)).2.3 Comparison of NIHSS scores:There was no significant difference in NIHSS scores between the two groups before treatment(P>0.05).After treatment,the NIHSS score of both groups decreased compared with that before treatment.The difference between the groups was statistically significant(P<0.001).Compared between the groups,the NIHSS score of the observation group decreased more significantly,and the difference was statistically significant(P<0.001).).2.4 Comparison of ADL scores:There was no significant difference in ADL scores between the two groups before treatment(P>0.05).After treatment,the ADL scores of the two groups were higher than before treatment.The difference between the groups was statistically significant(P<0.001);compared between the groups,the ADL score of the observation group increased more significantly,and the difference was statistically significant(P=0.027<0.05).3.Evaluation of efficacy:3.1 Evaluation of the efficacy of TCM syndrome points:The total effectiveness of the clinical efficacy of TCM syndrome points in the two groups was tested,P<0.05(x~2=-5.185,P=0.023);the efficacy grade of TCM syndrome points in the two groups of patients was tested by the Mann-Whitney U rank sum test,P<0.05(Z=-2.642,P=0.008),the effectiveness and efficacy grades of the observation group were better than the control group,and the difference was statistically significant.3.2 HAMD score curative effect evaluation:The total effective rate of HAMD score clinical efficacy of the two groups of patients was tested,P<0.05(x~2=4.629,P=0.031);the clinical efficacy grade of HAMD score of the two groups of patients was tested by Mann-Whitney U rank sum test,P<0.05(Z=-3.544,P<0.001),the effectiveness and efficacy of the observation group were better than the control group,the difference was statistically significant.Conclusion:1.Fangji Dihuang Decoction is used to treat kidney-yin deficiency type PSD with definite clinical efficacy,which can improve patients’TCM syndrome,improve patients’depression status,reduce neurological deficits,and improve daily living ability.2.Fangji Dihuang Decoction is safe for clinical application and has no obvious adverse reactions.