乌灵胶囊联合谷维素片治疗脑卒中后抑郁患者的效果及安全性分析

Efficacy and safety analysis of Wuling capsule combined with oryzanol tablet in the treatment of post-stroke depression

摘要:

目的 分析乌灵胶囊联合谷维素片治疗脑卒中后抑郁患者的效果及安全性。方法 选取2020年2月—2023年5月广东医科大学附属第二医院就诊的脑卒中后抑郁患者94例，采用随机数字表法分为研究组和对照组，每组47例。患者均接受常规治疗，对照组在该基础上采用谷维素片治疗，研究组在对照组的基础上采用乌灵胶囊治疗，持续治疗8周。对比两组神经功能、抑郁程度、临床疗效、睡眠质量、日常活动能力、炎症信号蛋白通路、神经递质、神经细胞因子及安全性。结果 研究组治疗前后的美国国立卫生研究院卒中量表评分、汉密尔顿抑郁量表评分的差值高于对照组（P <0.05）。研究组总有效率高于对照组（P <0.05）。研究组治疗前后匹茨堡睡眠质量指数评分、改良Barthel指数评分的差值均高于对照组（P <0.05）。研究组治疗前后的PI3K、Akt蛋白的差值均高于对照组（P <0.05）。研究组治疗前后的5-羟色胺、神经生长因子、脑源性神经营养因子、多巴胺、去甲肾上腺素的差值均高于对照组（P <0.05）。两组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 乌灵胶囊联合谷维素片可改善脑卒中后抑郁患者抑郁程度、神经功能、睡眠质量、日常活动能力，调节神经递质与神经细胞因子表达，疗效显著，可能与调节PI3K/Akt信号通路有关，且安全可靠。

Abstract:

Objective To analyze the efficacy and safety of Wuling capsule combined with oryzanol tablet in the treatment of post-stroke depression.Methods A total of 94 patients with post-stroke depression who were admitted to our hospital from February 2020 to May 2023 were included and divided into the study group and the control group by the random number table method, with 47 patients in each group. Along with conventional treatment in both groups, the control group received oryzanol tablets, and the study group received Wuling capsules plus oryzanol tablets. Both groups were treated for 8 weeks. Neurological function, depression, clinical efficacy, sleep quality, activities of daily living, inflammatory signaling pathways, neurotransmitters, neurotrophins and safety were compared between the two groups.Results The differences of National Institutes of Health Stroke Scale (NHISS) scores and Hamilton Depression Scale (HAMD) scores before and after treatment in the study group were higher than those in the control group (P < 0.05). The overall effective rate of the study group was higher than that of the control group (P < 0.05). The differences of Pittsburgh Sleep Quality Index (PSQI) and Modified Barthel Index (MBI) scores before and after treatment in the study group were higher than those in the control group (P < 0.05). The differences of protein expressions of PI3K and Akt before and after treatment in the study group were higher than those in the control group (P < 0.05). The differences of levels of 5-hydroxytryptamine (5-HT), nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), dopamine (DA) and norepinephrine (NE) before and after treatment in the study group were higher than those in the control group (P < 0.05). There was no significant difference in the overall incidence of adverse reactions between the two groups (P > 0.05).Conclusion Wuling capsule combined with oryzanol tablet demonstrate significant therapeutic efficacy by improving the degree of depression, neurological function, sleep quality, activities of daily living, and regulating the expressions of neurotransmitters and neurotrophins in patients with post-stroke depression, which may be related to the modulation of the PI3K/Akt signaling pathway. Besides, the treatment is safe and reliable.