Kidney And Liver Qi Treatment Of Stroke Clinical Studies Of Depression

Post-stroke depression (PSD) is an ever-present affective disorder after stroke having manifestations of depressing emotion, activity decrease, and sluggish ideation. As the most common complications of stroke, it is one of the chief causes of suicide in stroke patients, also results in heavy pecuniary burden for patients' family and the society. It has direct influence on patients' quality of life and functional recovery. In recent year, accompanied with the rising of the elderly and the high incidence rate of Cerebrovascular disease, the morbidity of PSD shows an upward tendency year after year. The research of PSD has aroused interest in many academicians of domestic and abroad. At present, the antidepressants in western medicine have some defects including slower effect, side-effect, expensive price and worse compliance. By contrast, Chinese Medicine has the advantage of less side effect through determination of treatment based on differentiation of syndromes as well as administering specific medications for illness. It is very important and necessary for patient's family and the society to probe into the etiology, pathogenesis and treatment of PSD with Chinese Medicine Theory, and same important with the research of pharmacodynamics and pharmacology of herb complex prescription which has exact curative effect on PSD.This thesis concerns prevention and cure of PSD with Chinese medicine, involving in 2 parts: summarization and clinical research.The summary part discussed progression of Chinese medicine and western medicine on etiology, pathogenesis and therapeutics of PSD, analyzed and confirmed the curative effect on PSD of some western medicines; and some single Chinese herbs and complex prescriptions; summarized the characteristic and superiority of determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs in Chinese medicine.Based on the systemic study of ancient pappers and present articles about PSD, combining with the academic cognition and clinical experience of PSD on medication of my tutor professor TangQisheng, a new viewpoint was put forward. Professor Tang thinks highly of body constitution in analysis of PSD etiopathogenisis and pathogenesis, upholds theory that deficiency of zang-fu organs and insufficiency of both kidney and liver caused by stroke are basic pathology of PSD. And then functional activity of Qi is not smooth and body fluid flow slowly, phlegm retention and blood stasis block the brain collaterals and the upper orifices, the marrow in the brain can not be nourished . The basic pathogenesis is insufficiency of kidney-Qi and deficiency of kidney-essence, the essential factors is qi stagnation and phlegm retention and blood stasis, and the key factor is the stagnation of Qi. Since the single method of soothing liver can not get satisfying effect, the principle of PSD treatment should include invigorating the kidney and smoothing liver, regulating vital energy and promoting blood flow, improving depression and anchoring the mind. This new principle of PSD treatment has many advantages compared with the former. We take this principle as our specificmethod.This research was a controlled, randomized clinical trial. 576 stoke outpatients and inpatients of the Dongzhimen hospital and Dongfang hospital affiliated to the Beijing University of Chinese Medicine have been observed. And 108 patients have been diagnosed as PSD. 62 patients assessed as PSD according to the diagnostic criteria were randomly divided into treatment and control group at the ratio of 1:1. 34 cases in treatment groups were cured by YinaojieyuTang(颐脑解郁方) combining with Herba Leonuri; 28 cases in control groups were cured by XiaoyaoSan(逍遥散) combining with Herba Leonuri. We contrasted the quantificat scores of symptoms in Chinese medicine and the scores of HAMD in order to analyze the curative effect and indication of YinaojieyuFang treating PSD, explain the idea in prescription compatibility and medication characteristic of YinaojieyuFang. Results: (1)The results showed that...