[1]罗 玮,李 耘,刘 玲.加味涤痰汤治疗卒中后抑郁疗效及对患者外周血NF-κB、miR-146a表达的影响[J].陕西中医,2019,(8):1029-1031，1048.
　LUO Wei,LI Yun,LIU Ling..Clinical effect of Jiawei Ditan decoction on post-stroke depressionand the expression of NF-κB and miR-146a in peripheral blood[J].,2019,(8):1029-1031，1048.
点击复制

加味涤痰汤治疗卒中后抑郁疗效及对患者外周血NF-κB、miR-146a表达的影响
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2019年8期
页码:
1029-1031，1048
栏目:
临床研究
出版日期:
2019-08-05

文章信息/Info

Title:
Clinical effect of Jiawei Ditan decoction on post-stroke depressionand the expression of NF-κB and miR-146a in peripheral blood
文章编号:
DOI:10.3969/j.issn.1000-7369.2019.08.012
作者:
罗 玮1; 李 耘2; 3; 刘 玲2; 3
1．江汉大学附属湖北省第三人民医院精神心理科（武汉 430030）；2.湖北省中医院脑病科（武汉 430061）；3.湖北中医药大学（武汉 430065）
Author(s):
LUO Wei; LI Yun; LIU Ling.
Mental Psychology，Hubei No.3 People's Hospital of Jianghan University (Wuhan 430030)
关键词:
脑卒中; 卒中后抑郁; 加味涤痰汤; 临床疗效; 核因子-κB; 微小核糖核酸-146a
Keywords:
Key words Stroke; Post-stroke depression; Jiawei Ditan decoction; Clinical efficacy; Nuclear factor-κB; MicroRNA-146a
分类号:
R749.41
文献标志码:
A
摘要:
摘 要 目的：观察加味涤痰汤对卒中后抑郁的临床疗效及外周血NF-κB、miR-146a表达的影响。方法：收集60例卒中后抑郁患者，随机分为治疗组和对照组，另选取10名健康者作为健康对照组（下称健康组），用以观察外周血清NF-κB、miR-146a含量水平。两组患者均给予西药抗抑郁药艾司西酞普兰片口服治疗，治疗组加用加味涤痰汤治疗。两组治疗的观察时间为8周，治疗前后分别比较两组的汉密尔顿抑郁量表（HAMD）评分、总疗效、Barthel评分、神经功能缺损评分（NIHSS评分）及对外周血NF-κB、miR-146a表达的影响。结果：HAMD评分上，治疗后两组均较前有差异（P＜0.05），且治疗组改善较对照组明显，差异有统计学意义（P＜0.05）。总疗效上，治疗组总有效率高于对照组（P＜0.05）。Barthel评分上，治疗后均较前升高，且治疗组升高更明显（P＜0.05）；NIHSS评分上，治疗后均较前降低，且治疗组降低更明显（P＜0.05）。两组NF-κB含量上，治疗前较健康组均升高（P＜0.01），治疗后与治疗前比较，两组治疗后NF-κB含量水平均降低（P＜0.01，P＜0.05），以治疗组降低更为明显（P＜0.05）。两组miR-146a水平上，治疗前较健康组均升高（P＜0.01），两组治疗后与治疗前比较miR-146a水平均降低（P＜0.05），两组治疗后miR-146a水平差异无统计学意义（P＞0.05）。结论：加味涤痰汤对卒中后抑郁疗效确切，能有效改善患者卒中后的HAMD评分、总疗效、Barthel评分、NIHSS评分，其作用机制可能与抑制NF-κB、miR-146a的含量表达、阻断炎症反应有关。
Abstract:
Abstract Objective：To observe the clinical effect of Jiawei Ditan decoction on post-stroke depression and the expression of NF-κB and miR-146a in peripheral blood. Methods：60 patients with post-stroke depression were randomly divided into treatment group and control group,and 10 healthy people were selected as healthy controls (hereinafter referred to as health group). To observe the levels of serum NF-κB and miR-146a in peripheral blood. Both groups of patients were given oral treatment with western medicine antidepressant escitalopram tablets,and the treatment group was treated with Jiawei Ditan decoction. The observation time of the two groups was 8 weeks. Before and after treatment,the Hamilton depression scale (HAMD) score,total efficacy,Barthel score,neurological deficit score (NIHSS score) and peripheral blood NF-κB,miR- were compared between the two groups. The effect of 146a expression. Results：The HAMD scores were significantly different between the two groups after treatment (P＜0.05),which was significantly higher than control group (P＜0.05). The total effective rat of the treatment group was higher (P＜0.05). On the Barthel score,the treatment was higher than before,and the treatment group was significantly higher (P＜0.05). The NIHSS score was lower than that before treatment,and the treatment group was more significant (P＜0.05). The levels of NF-κB in the two groups were higher than those in the healthy group before treatment (P＜0.01). After treatment,the levels of NF-κB decreased after treatment (P＜0.01,P＜0.05). The decrease in the treatment group was more pronounced (P＜0.05). The levels of miR-146a in the two groups were higher than those in the healthy group before treatment (P＜0.01). The miR-146a levels were lower after treatment (P＜0.05),and the levels of miR-146a after treatment. The difference was not statistically significant (P＞0.05). Conclusion：Jiawei Ditan decoction is effective in treating post-stroke depression. It can effectively improve the HAMD score,total curative effect,Barthel score and NIHSS score after stroke. The mechanism may be related to inhibiting the expression of NF-κB and miR-146a. Broken inflammatory response.

参考文献/References:

[1] 孙文哲,朱 舟,朱遂强.卒中后抑郁研究新进展[J].神经损伤与功能重建,2018,13(11):558-561.
[2] 中华神经科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996，29(6):60-61.
[3] 中华医学会精神病学分会.中国精神障碍分类与诊断标准第三版(精神障碍分类)[J].中华精神科杂志,2001,34(3):59-63.
[4] 国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准（试行）[J].北京中医药大学学报,1996,19(1):55-56.
[5] 国家中医药管理局.中医病症诊断疗效标准[M].南京：南京大学出版社，1994：15.
[6] 张小春,陈明锋.米氮平和艾司西酞普兰治疗脑卒中后抑郁患者的对照研究[J].中国现代药物应用,2019,13(1):105-106.
[7] 张子英.艾司西酞普兰治疗卒中后抑郁的疗效评价[J].临床研究,2018,26(12):99-100.
[8] 杨 琼.自拟开忧解郁方治疗脑卒中后抑郁症效果分析[J].深圳中西医结合杂志,2018,28(20):46-47.
[9] 罗 玮,刘 玲.加味涤痰汤治疗缺血性脑卒中后轻度认知障碍临床观察[J].陕西中医,2016,37(2):149-150，154.
[10] Ruey HS,Chen YW，Chuen MY .NF-kappaB signaling pathways in neurological inflammation:a mini review[J]. Frontiers in Molecular Neuroscience,2015,8:77.
[11] 王芳芳,张 冰.轻度认知障碍病人miRNA与脑DTI的相关性研究[J].国际医学放射学杂志,2016,39(4):361-365.
[12] 吕国天,王 爽,王庆坤.微小RNA-146a rs2910164及微小RNA-499 rs3746444与缺血性脑卒中的关系[J].新医学,2016,47(4):257-260.
[13] 朱 浩,赵 中.MicroRNA与阿尔茨海默病[J].国际神经病学神经外科学杂志,2013,40(5-6):462-466.
[14] 郭遂怀,张 鹏,陈爱春,等.涤痰汤对动脉粥样硬化兔模型炎性细胞因子的相关研究[J].中华中医药学刊,2017,35(5):1306-1309.
[15] 卢成淑,冯 宁,南 国,等.石菖蒲及其活性成分防治阿尔茨海默病的研究进展[J].中草药,2016,47(7):1236-1242.
[16] 李 杨，陆 倩，钱金栿.天南星提取物的抗炎作用及机制研究[J].大理学院学报，2013，12(9):14-16.

相似文献/References:

[1]吴春岚,王长德,陈 婡.逍遥解郁方对卒中后抑郁大鼠5HT含量及其受体表达影响的研究*[J].陕西中医,2019,(3):275.
　WU Chunlan,WANG Changde,CHEN Lai..Effect of Xiaoyao Jieyu recipe on 5HT content and its receptors expression of poststroke depressed rats[J].,2019,(8):275.
[2]金硕果,尹海燕,孙鸿辉△,等.三七对轻型缺血性脑卒中患者“双抗”治疗后出血事件影响的研究*[J].陕西中医,2019,(3):287.
　JIN Shuoguo,YIN Haiyan,SUN Honghui,et al.Impact study of Panax notoginseng on hemorrhagic event after treatment of dual antiplatelet therapy in patients with acute minor stroke[J].,2019,(8):287.
[3]张子英,吴伯涛,翟清华.益气活血法与化痰通络疗法对脑卒中症状治疗的应用价值探讨[J].陕西中医,2019,(2):250.
[4]樊锐敏.肝胃百合汤对脑卒中肠内营养患者胃肠道反应的影响[J].陕西中医,2019,(1):52.
　FAN Ruimin..Effect of Ganwei Baihe decoction on gastrointestinal reaction in patients with cerebral apoplexy enteral nutrition[J].,2019,(8):52.
[5]常雪利.针灸治疗对脑卒中后偏瘫颈肩痛患者疼痛改善及预后的影响*[J].陕西中医,2019,(4):525.
　CHANG Xueli..Analysis of the effect of acupuncture on pain improvement and prognosis in patients with hemiplegia neck shoulder and pain[J].,2019,(8):525.
[6]许文杰,蒋瑞冲,周一心,等.王翘楚教授经验方治疗肝郁瘀阻型脑卒中后失眠临床研究*[J].陕西中医,2019,(7):867.
　XU Wenjie,Jiang Ruichong,Zhou Yixin,et al.Therapeutic observation of experience prescription in party of professor Wang Qiaochu for post-stroke insomnia due to liver depression and blood stasis bolck[J].,2019,(8):867.
[7]蔡丽,刘毅,陆小青,等.神经复元方治疗缺血性卒中后抑郁临床研究*[J].陕西中医,2019,(11):1523.
　CAI Li,LIU Yi,LU Xiaoqing,et al.Shenjing Fuyuan decoction in the treatment of ischemic poststroke depression[J].,2019,(8):1523.
[8]萨仁,李长君,蔡海鑫.头穴丛刺对脑卒中后血管性痴呆患者认知功能及血清HIF1α的影响*[J].陕西中医,2019,(11):1622.
　SA Ren,LI Changjun,CAI Haixin..Effect of scalp acupuncture on cognitive function and serum HIF1α in patients with vascular dementia after stroke[J].,2019,(8):1622.
[9]王 佳 ,沈卫东△.头针、舌针联合康复训练治疗脑卒中后吞咽障碍疗效研究*[J].陕西中医,2019,(12):1774.
　WANG Jia,SHEN Weidong..Efficacy of scalp acupuncture and tongue acupuncture combined with rehabilitation training on dysphagia after cerebral stroke[J].,2019,(8):1774.
[10]刘兰兰,耿翊宁.经穴针刺对老年脑卒中患者脑灌注及血小板反应蛋白1水平影响研究[J].陕西中医,2019,(12):1778.
　LIU Lanlan,GENG Yining..Effect of acupoint acupuncture on cerebral perfusion and thrombospondin 1 in senile patients with stroke[J].,2019,(8):1778.
[11]蒋 岚,田慧军△,黄 伟.针灸联合黛力新治疗脑卒中后抑郁疗效及对患者血清神经递质水平的影响[J].陕西中医,2019,(8):1134.
　JIANG Lan,TIAN Huijun,HUANG Wei..Effects of Acupuncture combined with Deanxit on Post-stroke depression and its influence on serum neurotransmitters level[J].,2019,(8):1134.

更新日期/Last Update: 2019-08-15