知识与财富的链接
目的：探讨脑卒中后抑郁症的中医证候特征,为中药治疗脑卒中后抑郁症提供辨证依据。方法：对在安徽中医学院第一附属医院神经内科求治的病人进行神经功能、影像学、生化及神经心理学检查。根据脑卒中后抑郁症诊断标准,分为脑卒中后抑郁组、抑郁症组和脑卒中组,并对患者进行中医辨证。分析评价脑卒中后抑郁症的中医证候特征及其对脑卒中后抑郁症的相对危险度,以及中医证候与年龄的相关性。结果：脑卒中后抑郁组气滞血瘀证、肝气郁结证及气郁化火证积分显著高于脑卒中组（P〈0.05,P〈0.01）。脑卒中组主要以单证居多,而脑卒中后抑郁组和抑郁症组患者中,以3证及以上的复合证居多,其中肝气郁结证合并气郁化火或阴虚火旺证的比例较高,脑卒中后抑郁组和抑郁症组患者肝气郁结证的比例显著高于脑卒中组（P〈0.05,P〈0.01）;Logistic回归分析显示,与脑卒中后抑郁症相关的最危险的中医证候是气滞血瘀证,脑卒中组心脾两虚证积分与年龄呈正相关。结论：脑卒中后抑郁和抑郁症的主要证候特征是气滞血瘀、肝气郁结及气郁化火,其中脑卒中患者心脾两虚证具有年龄依赖性,而气滞血瘀证可以作为脑卒中后抑郁症独立的危险因素,证候越复杂,患者的抑郁程度越重。
Objective:To explore the main characteristics of syndromes in traditional Chinese medicine(TCM) in post-stroke depression(PSD) and to provide basis for treatments with TCM herbs.Methods:According to diagnostic criteria of PSD,stroke patients and depression patients from Department of Neurology,First Affiliated Hospital,Anhui University of Traditional Chinese Medicine were assigned into cerebral stroke group(150 cases),depression group(151 cases)and PSD group(123 cases).Neuropsy-chological assessments and imaging and biochemical analyses were conducted.TCM syndrome differentiation for these diseases was performed.We also determined the characteristics of TCM syndromes of PSD,relative risk of the syndromes and their correlations with ages as well.Results:Scores of qi stagnation and blood stasis,liver qi depression,and transformation of fire due to qi stagnation in PSD group were significant higher than those in cerebral stroke group(P<0.05,P<0.0 1).Incerebral stroke group,majority of the patients displayed one syndrome,while in PSD and depression groups,the patients had three or more syndromes.Of these syndromes,the incidence rate of syndrome of liver qi depression complicated with transformation of fire due to qi stagnation or flaring of fire due to yin deficiency was high.The syndrome of liver qi depression occurred much more frequently in PSD group and depression group than in cerebral stroke group(P<0.05,P<0.01).The logistic regression analysis showed that the syndrome of qi stagnation and blood stasis had high relative risk to PSD.The syndrome of deficiency of heart and spleen was positively correlated with age in cerebral stroke group.Conclusion:The main TCM syndromes of PSD and depression are qi stagnation and blood stasis,liver qi depression,and transformation of fire due to qi stagnation.The syndrome of deficiency of heart and spleen is closely related to age among the stroke patients.The syndrome of qi stagnation and blood stasis serves as an independent risk factor for PSD.The more complicated the Syndromes are,the more serious depression becomes.
