2023 年第 11 期 第 18 卷

安神补心丸联合阿戈美拉汀片治疗脑卒中后抑郁症伴失眠的临床效果研究

Clinical efficacy of Anshenbuxin pill combined with agomelatine tablets on patients with post-stroke depression with insomnia

作者：程娅雯1问雪宁2晏格致1李知衡1刘福德1

英文作者：Cheng Yawen1 Wen Xuening2 Yan Gezhi1 Li Zhiheng1 Liu Fude1

单位：1西安交通大学第一附属医院神经内科，西安710061；2鄂托克前旗人民医院内一科，鄂尔多斯016200

英文单位：1Department of Neurology the First Affiliated Hospital of Xi′an Jiaotong University Xi′an 710061 China; 2First Department of Internal Medicine Otog Front Banner People′s Hospital Ordos 016200 China

关键词：抑郁症；失眠；安神补心丸；阿戈美拉汀片

英文关键词：Depression;Insomnia;Anshenbuxinpill;Agomelatinetablets

• 摘要：

• 目的  探讨安神补心丸联合阿戈美拉汀片治疗脑卒中后抑郁症伴失眠的临床效果。方法  选取2018年6月至2021年12月西安交通大学第一附属医院收治的80例脑卒中后抑郁症伴失眠患者，依照随机数字表法分为对照组和观察组，各40例。对照组口服阿戈美拉汀片治疗，观察组在对照组基础上口服安神补心丸，2组均连续治疗6周。比较2组治疗前后汉密尔顿抑郁量表（HAMD）、匹兹堡睡眠质量指数（PSQI）评分，血清超氧化物歧化酶（SOD）、丙二醛、脑源性神经营养因子（BDNF）、肿瘤坏死因子α（TNF-α）、白细胞介素2（IL-2）、IL-6水平。记录患者临床疗效及治疗期间不良反应发生情况。结果  治疗后，2组HAMD、PSQI评分均低于治疗前，且观察组均低于对照组［（11.0±2.6）分比（13.5±3.1）分、（5.1±2.0）分比（7.9±2.8）分］（均P<0.05）；2组血清SOD、BDNF水平均高于治疗前，且观察组均高于对照组（均P<0.05），丙二醛、TNF-α、IL-2、IL-6水平均低于治疗前，且观察组均低于对照组，差异均有统计学意义（均P<0.05）。观察组总有效率高于对照组［90.0%（36/40）比70.0%（28/40）］（P=0.025）。治疗期间，2组不良反应发生率比较差异无统计学意义（P>0.05）。结论  安神补心丸联合阿戈美拉汀片治疗脑卒中后抑郁症伴失眠的临床效果较好，能有效缓解抑郁和失眠症状，且安全性好。

• Objective  To investigate the clinical efficacy of Anshenbuxin pill combined with agomelatine tablets on patients with post-stroke depression with insomnia. Methods  Totally 80 cases of patients with post-stroke depression with insomnia admitted to the First Affiliated Hospital of Xi′an Jiaotong University from June 2018 to December 2021 were selected. According to the random number table method, they were divided into the control group and the observation group, with 40 cases in each group. The control group was treated with agomelatine tablets orally, the observation group was treated with Anshenbuxin pill orally based on the control group, and both groups were treated for 6 weeks. The Hamilton Depression Scale (HAMD) score, Pittsburgh Sleep Quality Index (PSQI) score, serum superoxide dismutase (SOD), malondialdehyde (MDA), brain-derived neurotrophic factor (BDNF), tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2), and IL-6 levels of the two groups were compared before and after treatment. The clinical effect and incidence of adverse reactions of the two groups during treatment were recorded. Results  After treatment, the scores of HAMD and PSQI in both groups were lower than those before treatment, and the scores in the observation group were lower than those in the control group ［（11.0±2.6） vs （13.5±3.1）,（5.1±2.0） vs （7.9±2.8）］（all P<0.05）; serum levels of SOD and BDNF in both groups were higher than those before treatment, and the levels in the observation group were higher than those in the control group (all P<0.05); levels of MDA, TNF-α, IL-2 and IL-6 in both groups were lower than those before treatment, and the levels in the observation group were lower than those in the control group (all P<0.05). The totally effective rate in the observation group was higher than that in the control group ［90.0%（36/40） vs 70.0%（28/40）］（P=0.025）. During treatment, there was no statistical difference of the incidence of adverse reactions between the two groups （P>0.05）. Conclusions    The therapeutic effect of Anshenbuxin pill combined with agomelatine tablets on patients with post-stroke depression with insomnia is significant. It can promote the disappearance of depressive symptoms, and has good safety.