| Abstract |
Objective To explore the efficacy of Chaihu Dayu decoction combined with Xingnao Kaiqiao method with acupuncture and moxibustion in the treatment of elderly post-stroke depression (PSD) and its influence on neurological function, depression score and levels of serum brain-gut peptide, homocysteine (Hcy) and neuropeptide Y(NPY). Methods 118 patients with PSD were selected and randomly divided into acupuncture group and acupuncture-medication group, with 59 cases in each group. Acupuncture group was treated with Xingnao Kaiqiao method with acupuncture and moxibustion, and acupuncture-medication group was treated with Chaihu Dayu decoction on the basis of above treatment. After 8 weeks of treatment, the changes in TCM symptoms scores before and after treatment and efficacy of TCM syndromes after 8 weeks of treatment were observed in the two groups. The depression status [Hamilton Depression Scale (HAMD)], neurological impairment degree [Modified Edinburgh-Scandinavian Stroke Scale (MESSS)] and serum biochemical indicators [5-hydroxytryptamine (5-HT), somatostatin (SS), vasoactive intestinal peptide (VIP), Hcy, NPY] were compared between the two groups before treatment and after 8 weeks of treatment. Results After 8 weeks of treatment, the scores of six items of TCM symptoms of depression and worry, quietness, restlessness, insomnia and forgetfulness, irritability and crying and indifferent expression and total score in the two groups were significantly decreased compared with those before treatment (P<0.05), and the scores in acupuncture-medication group were significantly lower than those in acupuncture group (P<0.05). After 8 weeks of treatment, the efficacy of TCM syndromes of depression in acupuncture-medication group was significantly higher than that in acupuncture group (94.92% vs 81.36%) (P<0.05). Comparisons of HAMD-24 score and MESSS score at different time points between the two groups showed significant differences from the aspects of time-point effect, between-group effect and interaction effect (P<0.05), and the above scores after 2, 4 and 8 weeks of treatment in both groups were significantly lower than those before treatment (P<0.05), and the scores in acupuncture-medication group were significantly lower compared with those in acupuncture group (P<0.05). The levels of serum 5-HT, SS, VIP and NPY in the two groups after 8 weeks of treatment were significantly enhanced compared with those before treatment (P<0.05), and the levels in acupuncture-medication group were significantly higher than those in acupuncture group (P<0.05). Serum Hcy level in the two groups was significantly reduced compared to before treatment (P<0.05), and serum Hcy level was significantly lower in acupuncture-medication group than that in acupuncture group (P<0.05). Conclusion Chaihu Dayu decoction combined with Xingnao Kaiqiao method with acupuncture and moxibustion has significant efficacy in the treatment of PSD. It can improve the TCM symptoms, depression and neurological impairment, correct the disorder of serum brain-gut peptide, inhibit the level of serum Hcy, and enhance the expression of serum NPY so as to play a significant antidepressant effect.Key words: Chaihu Dayu decoction; Xingnao Kaiqiao method with acupuncture and moxibustion; Post-stroke depression; Neurological function; Depressive status; Serum 5-HT; Serum Hcy; Serum NPY
|