按摩与康复医学
按摩與康複醫學
안마여강복의학
Chinese Manipulation & Rehabilitation Medicine
2015年
13期
12-14
,共3页
中风后抑郁%柴胡加龙骨牡蛎汤%细胞因子%IL-1β%TNF-α%神经功能
中風後抑鬱%柴鬍加龍骨牡蠣湯%細胞因子%IL-1β%TNF-α%神經功能
중풍후억욱%시호가용골모려탕%세포인자%IL-1β%TNF-α%신경공능
post-stroke depression%bupleurum decoction plus dragon bone ad oyster shell%cytokines%IL-1β%TNF-α%nerve function
目的:观察柴胡加龙骨牡蛎汤对中风后抑郁(PSD)患者血清细胞因子表达的影响。方法:将58例PSD患者随机分为观察组(28例)和对照组(32例),另选取20例脑梗死无抑郁患者纳入基础组,三组患者均给予基础治疗(抗血小板聚集、控制血压、控制血糖、脱水治疗、康复治疗、心理治疗和心理护理等),对照组在此基础上服用盐酸氟西汀片(20mg,qd),观察组则服用柴胡加龙骨牡蛎汤(柴胡、黄芩、姜半夏等),采用双抗体夹心酶标免疫分析法(ELISA)测定患者的血清细胞因子白细胞介素-1β(IL-1β)、肿瘤坏死因子α(TNF-α)的水平,并在治疗第1、28天进行神经功能学评分(Barthel指数、NIHSS),观察其评分变化。结果:与对照组比较,观察组第14、28天的血清IL-1β及TNF-α浓度均显著降低(P<0.05),HAMD、NIHSS评分及Barthel指数均显著改善(P<0.01)。结论:柴胡加龙骨牡蛎汤能有效改善PSD患者的神经功能及抑郁状态,机制可能与抑制PSD患者炎症反应有关。
目的:觀察柴鬍加龍骨牡蠣湯對中風後抑鬱(PSD)患者血清細胞因子錶達的影響。方法:將58例PSD患者隨機分為觀察組(28例)和對照組(32例),另選取20例腦梗死無抑鬱患者納入基礎組,三組患者均給予基礎治療(抗血小闆聚集、控製血壓、控製血糖、脫水治療、康複治療、心理治療和心理護理等),對照組在此基礎上服用鹽痠氟西汀片(20mg,qd),觀察組則服用柴鬍加龍骨牡蠣湯(柴鬍、黃芩、薑半夏等),採用雙抗體夾心酶標免疫分析法(ELISA)測定患者的血清細胞因子白細胞介素-1β(IL-1β)、腫瘤壞死因子α(TNF-α)的水平,併在治療第1、28天進行神經功能學評分(Barthel指數、NIHSS),觀察其評分變化。結果:與對照組比較,觀察組第14、28天的血清IL-1β及TNF-α濃度均顯著降低(P<0.05),HAMD、NIHSS評分及Barthel指數均顯著改善(P<0.01)。結論:柴鬍加龍骨牡蠣湯能有效改善PSD患者的神經功能及抑鬱狀態,機製可能與抑製PSD患者炎癥反應有關。
목적:관찰시호가용골모려탕대중풍후억욱(PSD)환자혈청세포인자표체적영향。방법:장58례PSD환자수궤분위관찰조(28례)화대조조(32례),령선취20례뇌경사무억욱환자납입기출조,삼조환자균급여기출치료(항혈소판취집、공제혈압、공제혈당、탈수치료、강복치료、심리치료화심리호리등),대조조재차기출상복용염산불서정편(20mg,qd),관찰조칙복용시호가용골모려탕(시호、황금、강반하등),채용쌍항체협심매표면역분석법(ELISA)측정환자적혈청세포인자백세포개소-1β(IL-1β)、종류배사인자α(TNF-α)적수평,병재치료제1、28천진행신경공능학평분(Barthel지수、NIHSS),관찰기평분변화。결과:여대조조비교,관찰조제14、28천적혈청IL-1β급TNF-α농도균현저강저(P<0.05),HAMD、NIHSS평분급Barthel지수균현저개선(P<0.01)。결론:시호가용골모려탕능유효개선PSD환자적신경공능급억욱상태,궤제가능여억제PSD환자염증반응유관。
Objective:To observe the influence of bupleurum decoction plus dragon bone ad oyster shell on the expression of serum cytokines IL-1βand TNF-αin patients with post-stroke depression (PSD). Methods:58 cases of PSD patients were randomly divided into observation group (28 cas-es) and control group (32 cases), and 20 cases stroke patients who without depression were brought into basic group, all of the three groups were treated by basic treatment (such as anti-platelet aggregation, blood pressure and glucose control, dehydration therapy, rehabilitation therapy, psycho-therapy and psychological nursing); on the basis of it, the control group combined with orally taking fluoxetine hydrochloride tablets (20mg, qd), while observation group combind with orally taking bupleurum decoction plus dragon bone ad oyster shell (bupleurum falcatum, scutellaria baicalen-sis, pinellia ternata that prepared with ginger juice, etc), then used ELISA to test the level of serum cytokines IL-1βand TNF-α, and evaluated the nerve function with neurological scores (Barthel index, NIHSS) at the first and 28th day of treatment, observed the change of the scores. Results:Compared with control group, the concentration of serum IL-1βand TNF-αof observation group were both significantly decreased at the 14th and 28th day (P<0.05), the HAMD, NIHSS scores and Barthel index were all significantly improved (P<0.01). Conclusion:Bupleurum decoction plus dragon bone ad oyster shell can effectively improve the nerve function and depressive state of PSD patients, its mechanism may be related to the inhi-bition of inflammatory reaction in PSD patients.