The Study On Development Law Of TCM Syndrome Factors Of Depression After Ischemic Stroke And Effect Of Differential Treatment With Anti-depression On Post-stroke Depression:a Randomized Controlled Trial

Objective①To Explore the relationship between the post-stroke depression (PSD) with gender, age, stroke site, the degree of neurological deficit and TCM syndrome elements, and to look for risk factors that may have contributed to PSD.②A Randomized Controlled Trial was Designed to Explore the role of Small Compound Prescriptions to reduce PSD incidence after acute ischemic stroke under guidance of the theory of TCM.Methods①To study the dynamic evolution of TCM syndrome elements of the first acute ischemic stroke patients and to look for the risk factors which may have contributed to the PSD by Retrospective study with acute ischemic stroke patients.②Previous study found that the most important of the three TCM syndrome factors in PSD were phlegm, blood stasis and qi deficiency. According to the different period the three syndrome factors appeared and their different degrees, the patients of acute ischemic stroke was given the small compound Prescriptions under guidance of the theory of TCM by Randomized controlled study.Results①The study found the most prominent early onset syndrome factor was wind syndrome, which significant declines with time passing.At the same time, qi deficiency symptoms raised gradually, and phlegm syndrome, blood stasis syndrome Gradually increased as the dominant factors which persisted the entire acute phase.②The study found there was no Correlations between the age, gender, Left or right side of the lesion in the brain with PSD. But it seems more likely to occur in the brain lobe infarction or multiple infarction.③The more serious neurological deficit, the greater the likelihood of PSD. Neurological deficit is one of the risk factors affect the PSD occurred.④Phlegm syndrome, blood stasis, qi deficiency were the main TCM syndrome factors which impact of PSD occurs.⑤The area under the ROC curve to predicted PSD after ischemic stroke of NIHSS score, phlegm and blood stasis syndrome accumulated scores were0.737,0.760,0.652respectively. Their diagnostic cut off points were9.5,9.5, and13.5scores which could be good for the early diagnosis of PSD.⑥PSD incidence of the treatment group compared with the control group decreased, there is statistical difference between the two groups, P<0.05. Recovery of neurological function was significantly better than the control group, there is statistical difference between the two groups, P<0.01.Conclusion①Phlegm syndrome, blood stasis and qi deficiency may the main syndrome factors that will promote PSD occurred after ischemic stroke.②Clinicians could pay attention to the development of Syndrome Factors, especially the phlegm, blood stasis and qi deficiency.③Through the observation of the TCM syndrome factors can prediction PSD in advance. It provides the theoretical basis for the treatment of PSD by TCM.④The formula combination of anti-depression small Compound Prescriptions reflects the principles of TCM diagnosis and treatment. It can reduce phlegm, Invigorate the circulation, supply qi, Improve the neurological deficit after stroke and reduce the incidence of PSD. This method reflects the theory of traditional Chinese medicine to prevent disease.