Han Hui, Wu Li-min, Yang Wen-Ming, Wang Mei-xia, Tang Jing-jing, Wang Han, Liu Zhi-xiu, Liu Rong-zhi, Dong Ting, Zhang Juan, Yang Bo, Han Ming-xiang
Department of Neurology, Anhui University of Traditional Chinese Medicine, Hefei, China.
Zhong Xi Yi Jie He Xue Bao. 2010 May;8(5):427-31. doi: 10.3736/jcim20100505.
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.
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). Neuropsychological 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.
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<0.01). In cerebral 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.
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.
探讨中风后抑郁（PSD）的中医证候主要特征，为中药治疗提供依据。
依据PSD诊断标准，将安徽中医药大学第一附属医院神经内科的中风患者、抑郁患者分为脑卒中组（150例）、抑郁组（151例）和PSD组（123例）。进行神经心理学评估、影像学及生化分析。对这些疾病进行中医辨证。我们还确定了PSD的中医证候特征、证候的相对风险及其与年龄的相关性。
PSD组气滞血瘀、肝郁气滞、气郁化火得分显著高于脑卒中组（P<0.05，P<0.01）。脑卒中组多数患者表现为一种证候，而PSD组和抑郁组患者有三种或更多证候。在这些证候中，肝郁气滞兼气郁化火或阴虚火旺证候的发生率较高。肝郁气滞证候在PSD组和抑郁组的发生率显著高于脑卒中组（P<0.05，P<0.01）。Logistic回归分析显示，气滞血瘀证候发生PSD的相对风险较高。脑卒中组心脾两虚证候与年龄呈正相关。
PSD和抑郁的主要中医证候为气滞血瘀、肝郁气滞、气郁化火。中风患者中心脾两虚证候与年龄密切相关。气滞血瘀证候是PSD的独立危险因素。证候越复杂，抑郁越严重。
