The Clinical Research Of Wenyangtongmai Granule For Treatment Of Patients In Pi-shen-yang-xu-type With Depression After Ischemic Stroke

Objectives: The study through com Parative observation TCM syndrome grade score of pi-shen-yang-xu-ty Pe,HAMD,NIHSS,MMSE,ADL,HCY before and after the treatment which of pi-shen-yang-xu-ty Pe Patients with depression after ischemic storke by Wenyang Tongmai Granule and duloxetine,and evaluate whether the treatment can benefit the pi-shen-yang-xu-type patients of ischemic Post-stroke depression.As a result to provide new train of thought for clinical treatment of ischemic Post-stroke depression patients.Methods: We selected 60 examples patients with ischemic post-stroke depression which all were from rehabilitation clinic or ward of tongling traditional chinese medicine hospital.All these patients were randomly divided into treatment group(Wenyang Tongmai Granule method,combined with duloxetine treatment)and control group(duloxetine treatment),and each group had 30 cases,both groups were given basic treatment(basic drugs,rehabilitation and psychological intervention)with duloxetine,treatment group used Wenyang Tongmai granule according to the theory of wen-bu-pi-shen ? yang-xue-tong-mai.The course of the treatment was 4 weeks.The scores of the self-made traditional Chinese medicine syndromes of post-stroke depression rating scale?The scores of HAMD?the scores of neural function defect(NIHSS),the score of the ability of daily life(ADL)? the score of Mini-mental State Examinatlon(MMSE)were measured before and after treatment for 2 weeks,4 weeks of treatment and 8 weeks after treatment.After the comparison between the treatment group and the control group,discuss the trclinical efficacy of the treatment of post-stroke depression by Wenyang Tongmai Granule,and give another way of the treatment of ischemic post-stroke depression patients by combination of Chinese and Western Medicine.Results:1.General information : There are 60 cases of patients.29 cases were male which accounted for 48.3%;31 cases were female which accounted for 51.7%.there was a high incidence of this disease in women than in men;the most high proportion in the lesion statistics was basal ganglia which is up to 53.3%;Smokers accounted for 43.3%;Drinking 24 cases accounted for 40%;previous stroke Stem 23.3%;in the past history of hypertension,diabetes and dyslipidemia accounted for the top three.There was no significant difference(P> 0.05)between the treatment group and the control group in terms of age,sex,educational level,Course of disease,alcohol and tobacco history and past medical history.2.The change of the scores of two groups before and after treatment evaluation scale:(1)Comparison of the each groups: The comparison of traditional Chinese medicine syndrome scores and reduction rate,HAMD score and reduction rate,NIHSS score,MMSE score,ADL score before and after treatment were statistically significant different(P<0.01 or P<0.05),suggesting that both groups can improve ischemia Post-stroke depression in patients with depressive symptoms,neurological function and self-care ability;(2)Comparison between two groups: There was significant difference between the two groups in the scores of TCM symptom and the reduction rate,HAMD score,NIHSS score and ADL score were statistically significant different(P<0.01 or P<0.05)before and after 2 weeks treatment,and a statistically significant different(P<0.01 or P<0.05)after 4 weeks treatment as well,At the time of 8 weeks of treatment,the scores of TCM scores and scores reduction rate,HAMD score,NIHSS scores were statistically significant different(P<0.01 or P<0.05).The results show that the treatment of ischemic post-stroke depression patients.with Wenyang Tongmai Granule combined with duloxetine can improve the quality of depressive symptoms,neurological deficits,improvement of cognitive function and improve the quality of life of patients.And can show the efficiency faster than the control group,and the advantage can last for a long time.3.Laboratory tests(serum HCY values):There was a significant difference in the decline of HCY between the treatment group and the control group(P<0.05),but there was no significant difference between the two groups after 8 weeks of treatment(P>0.05).It was confirmed elementarily that PSD was associated with serum HCY in patients with ischemic stroke.The combination of Wenyang Tongmai granule and duloxetine which is a method of combining with traditional Chinese and western medicine for the treatment of ischemic stroke had no negative effect on HCY.4.Safety assessment:During the course of treatment,there was no significant adverse event in the two groups.After 8 weeks of treatment,review the blood samples and ECG as a result no significant difference compared with on admission.To prompted Wenyang Tongmai Granule and duloxetine treatment of PSD high safety.Conclusion: The treatment of ischemic post-stroke depression patients by using Wenyang Tongmai Granule and duloxetine,which is a method of the combination of traditional Chinese and western medicine,have a faster effect,a lasting medicinal effect,a shorten course of treatment,good safety,good compliance,and a better effect,by compared with single use of duloxetine in the treatment of ischemic post-stroke depression patients.And PSD was associated with serum HCY in patients with ischemic stroke.Clinical attention should be paid to the treatment of hyperhomocysteinemia.