Clinical Research And Analysis In The Treatment Of Post-Stroke Depression Patients Using XIAOSHUAN Enteric-coated Capsule With Mirtazapine

BackgroundPost-stroke Depression (PSD) is one of the common complications in brain Stroke patients with the incidence up to 30%-50%. In traditional Chinese medicine, this disease belongs to the "stroke" and "yu", within the category of "epilepsy disease". Different levels of depressive symptoms and duration more than 2 weeks are common manifestations in patients, and it causes the body and mind as well as the economic burden for their family. Increased incidence of cerebrovascular accident in our country, the emergence of PSD increased year by year.ObjectiveTo defected the more effective treatment of PSD, we carried out this clinical research on the patients with PSD using XIAOSHUAN Enteric-coated Capsule with mirtazapine.MethodsA total of 77 patients diagnosed as PSD were choosed from outpatient and the inpatient from May 2013 to December 2014 in our hospital. There groups were divided according to the hidden method, one group using mirtazapine and the observation group combined with two XIAOSHUAN Enteric-coated Capsule with mirtazapine, with each group cases of 41 and 36. Basic routine treatment were used in all patients and the rest of the risk factors, such as blood pressure, blood sugar, blood fat, et al were controlled. The Milton-24 depression scale (HAMD) scores, stroke scale (NIHSS) scores, active ability of daily life (ADL) scale (Barthel index) evaluation and overall curative effect evaluation and long-term side effects were evaluated after 4 and 8 weeks in three groups. SPSS 16.0 statistical software were used to perform single factor analysis of variance in age, course of comparison, and repeated-measures ANOVA was used to analyse HAMD scores, NIHSS score and ADL score. Categorical data including curative effect judgment using nonparametric Mann-Whitneytest, whereas count data by x2 test, alpha=0.05 as the inspection level, P<0.05 was considered statistically significant.Results(1) There was significant difference among three groups of HAMD scores (P<0.05). HAMD score of observation group was significantly lower than the control group after 4 weeks, and the lowest scores of HAMD was observed in observation groups after 8 weeks. The symptoms of depression in PSD Patients improved in the observation group than the control group. (2) The NIHSS score of the observation group was significantly lower than the control group after treatment of 4 and 8 weeks. The curative effect of nerve function defect in patients have improved significantly in observation group than the control group. (3) The ADL score of the observation group was significantly higher than the control group after treatment of 4 and 8 weeks, and with the increasing of the time, the ADL score is increasing without significant difference in two groups. (4) In the curative PSD patients after treatment, recurrence cases of three groups were found but with no significant difference, however, recurrence rate was significant lower in the observation group than in control group after 8 weeks.ConclusionsThe improvement of HAMD score, depression overall improvement, NIHSS score, improve neurologic deficits, active ability of daily life (ADL)in patients treated with XIAOSHUAN Enteric-coated Capsule and mirtazapine is superior than oral simple mirtazapine. Furthermore, the low long-term recurrence and adverse reactions were found in observation group, and worthy of clinical promotion.