目的 观察养血清脑颗粒联合米氮平治疗脑卒中后抑郁伴失眠的效果.方法 选取100例脑卒中后抑郁伴失眠的患者,按随机数字表法分为观察组与对照组各50例.对照组应用米氮平治疗,观察组在对照组基础上联合养血清脑颗粒治疗,两组均治疗8周.比较两组治疗前、治疗4周、治疗8周后患者的抑郁程度[采用汉密顿抑郁量表(HRSD)进行评估]、睡眠质量[采用匹茨堡睡眠质量指数量表(PSQI)进行评估]、5-HT和NE水平、副反应情况[副反应量表(TESS)进行评估].结果 两组治疗后的HRSD评分与PSQI评分均显著下降(P<0.05);观察组治疗4周与8周后的HRSD评分和PSQI评分均显著低于对照组(P<0.05).治疗后两组血清5-HT和NE水平均显著升高,且观察组治疗后的血清5-HT与NE水平均显著高于对照组(P<0.05).两组TESS评分与各项副反应发生率的差异均无统计学意义(P>0.05).结论 养血清脑颗粒联合米氮平治疗脑卒中后抑郁伴失眠可有效改善患者抑郁与失眠情况,且安全性高,值得推广.%Objective To observe the effect of Yangxue Qingnao granules combined with mirtazapine in the treatment of stroke depression with insomnia. Methods A total of 100 patients with post-stroke depression and insomnia were selected and randomly divided into the observation group and control group with 50 cases in each group. The control group was treated with mirtazapine, the observation group was treated with Yangxue Qingnao granules on the basis of the control group, and the treatment course was for 8 weeks. The depression degree and sleep quality before treatment, after treatment for 4 weeks and 8 weeks were evaluated by the Hamilton rating scale for depression (HRSD) score and Pittsburgh sleep quality index (PSQI), respectively. The levels of 5-Hydroxytryptamine (5-HT) and norepinephrine (NE) were determined. The incidence of side effects during treatment was measured by Treatment Emergent Symptom Seale (TESS). Results The HRSD score and PSQI score after treatment decreased significantly in both groups (P<0.05). After treatment for 4 weeks and 8 weeks, the HRSD and PSQI scores of the observation group were significantly lower than those of the control group (P<0.05). These levels of 5-HT and NE in the observation group after treatment were significantly higher than the control group (P<0.05). There were no significant difference between the two groups in TESS score and incidence of side effects (P>0.05). Conclusion The Yangxue Qingnao granules combined with mirtazapine shows obvious effect and high safety in the treatment of stroke depression with insomnia.
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