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[目的]观察逍遥散加味联合氟西汀治疗中风后抑郁症疗效。[方法]使用随机平行对照方法,将102例住院及门诊患者按掷骰子方法简单随机分为两组,心理干预,健康教育,详细讲解治疗原理与方法。对照组51例氟西汀,20mg/次,1次/d,口服。治疗组51例逍遥散:当归、白芍、茯苓、白术、生姜各15g,炙甘草、柴胡、薄荷各6g,水煎400mL,早晚温服;肝气郁结加郁金、川芎、香附,血瘀刺痛加桃仁、丹参,心神失养、眩晕失眠加百合、生龙骨、远志、牡蛎,脾虚乏力、不思饮食加黄芪、党参、龙眼;氟西汀治疗同对照组。连续治疗60d为1疗程。观测临床症状、HAMD评分、不良反应。治疗1疗程(60d),判定疗效。[结果]治疗组显效37例,有效10例,无效4例,总有效率92.16%;对照组显效23例,有效13例,无效15例,总有效率70.59%;治疗组疗效优于对照组(P<0.01)。HAMD评分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]逍遥散加味联合氟西汀治疗中风后抑郁症,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the therapeutic effect of Xiaoyaosan plus fluoxetine on depression after stroke. [Methods] Using randomized parallel control method, 102 inpatients and outpatients were randomly divided into two groups according to the dice method, psychological intervention, health education, explain the treatment principle and method in detail. Control group, 51 cases of fluoxetine, 20mg / time, 1 / d, orally. Treatment group, 51 cases of Xiaoyao San: Angelica, white peony root, Poria, Atractylodes, ginger 15g, Baked Licorice, Bupleurum, peppermint 6g, decoction 400mL, morning and evening warm clothes; liver qi stagnation plus turmeric, Chuanxiong, Cyperus rotundus, blood Stasis sting with peach, Salvia, mind loss, dizziness insomnia plus lily, Health keel, Polygalaceae, oysters, spleen deficiency, do not think diet plus Astragalus, Codonopsis, longan; Fluoxetine treatment with the control group. Continuous treatment of 60d for a course of treatment. Clinical symptoms, HAMD score, adverse reactions were observed. Treatment of a course of treatment (60d), to determine the efficacy. [Results] In the treatment group, 37 cases were markedly effective, 10 cases were effective, 4 cases were ineffective, and the total effective rate was 92.16%. In the control group, 23 cases were markedly effective, 13 cases were effective and 15 cases were ineffective. The total effective rate was 70.59% (P <0.01). HAMD score improved in both groups (P <0.01), the treatment group improved better than the control group (P <0.01). [Conclusion] Xiaoyaosan flavored fluoxetine combined with fluoxetine in the treatment of post-stroke depression has satisfactory curative effect and no serious adverse reactions, which deserves promotion.