黛力新与多塞平治疗脑卒中后抑郁的临床疗效及其对神经介质水平的影响
Clinical effect of deanxit and doxepin in the treatment of post-stroke depression and its effect on the neurotransmitter level
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摘要: 目的：探讨黛力新与多塞平对脑卒中后抑郁的临床疗效，并比较其对病人神经介质水平的影响。方法：选取脑卒中后抑郁病人80例，随机分为黛力新组和多塞平组，各40例，分别给予黛力新和多塞平，均治疗8周。采用汉密顿抑郁量表（HAMD）、美国国立卫生研究院卒中量表（NIHSS）和Barthel指数对2组病人的临床疗效进行评估，并采用荧光分光光度计法检测2组血浆5-羟色胺（5-HT）、多巴胺（DA）水平，采用高效液相色谱法检测2组血浆去甲肾上腺素（NE）水平。结果：黛力新组总有效率明显优于多塞平组（P<0.01）。2组病人治疗后HAMD、NIHSS量表评分均较治疗前显著降低（P<0.01），Barthel指数均较治疗前显著升高（P<0.01）；且黛力新组治疗后第2、4、8周的HAMD评分均低于多塞平组（P<0.05~P<0.01），Barthel指数均高于多塞平组（P<0.05~P<0.01），治疗后第8周的NIHSS量表评分显著低于多塞平组（P<0.01）。2组病人治疗后5-HT、DA及NE水平均较治疗前明显升高（P<0.01），且黛力新组病人的5-HT、DA及NE的水平升高程度均显著高于多塞平组（P<0.01）。2组不良反应发生率差异均无统计学意义（P>0.05）。结论：黛力新对脑卒中后抑郁具有良好疗效，并能够有效提高病人神经介质的表达水平，促进病人神经功能的恢复，从而改善病人的日常生活能力，具有较高安全性，值得临床推广。Abstract: Objective:To investigate the clinical effects between deanxit and doxepin in the treatment of post-stroke depression,and its effects on the neurotransmitter level.Methods:Eighty patients with post-stroke depression were randomly divided into the deanxit group and doxepin group(40 cases each group).The deanxit group and doxepin group were treated with the deanxit and doxepin for 8 weeks,respectively.The clinical effects between two groups were evaluated using the Hamilton Depression Rating Scale(HAMD),US National Institutes of Health Stroke Scale(NIHSS) and Barthel index(BI).The levels of 5-HT and DA in two groups were detected by fluorescence spectrophotometer method,and the level of NE in two groups were detected by high performance liquid chromatography(HPLC).Results:The total effective rate in deanxit group was significantly better than that in doxepin group(P<0.01).Compared before treatment,the scores of HAMD and NIHSS,and Barthel index in two groups significantly decreased and increased after treatment,respectively(P<0.01),After 2,4 and 8 weeks of treatment,the HAMD scores in deanxit group were lower than those in doxepin group(P<0.05 to P<0.01),and the Barthel index in deanxit group was higher than that in doxepin group(P<0.05 to P<0.01).The NIHSS score in deanxit group after 8 weeks of treatment was significantly lower than that in doxepin group(P<0.01).Compared before treatment,the levels of 5-HT,DA and NE in two groups significantly increased after treatment(P<0.01),and the incrasing degree of 5-HT,DA and NE levels in deanxit group were significantly higher than those in doxepin group after treatment(P<0.01).The difference of the incidence rate of adverse reaction between two groups was not statistically signficant(P>0.05).Conclusions:The treatment of post-stroke depression with deanxit is good effect and safe,which can effectively increase the neurotransmitter level,promote the nerve function recovery,improve the daily life ability of patients,and is worthy of clinical use.
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Key words:
- stroke /
- depression /
- deanxit /
- doxepin
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