目的 探究盐酸度洛西汀联合枸橼酸坦度螺酮对脑卒中后抑郁的效果及血清5-羟色胺(5-hydroxy tryptamine，5-HT)、去甲肾上腺素(norepinephrine，NE)、同型半胱氨酸(homocysteine，Hcy)水平的影响。方法 研究对象选择2020年9月至2022年9月期间许昌市中心医院收治的80例脑卒中后抑郁患者，数字表法随机将其分为对照组(40例，给予枸橼酸坦度螺酮)和联合组(40例，枸橼酸坦度螺酮联合盐酸度洛西汀肠溶胶囊)，治疗4周后，对比两组患者抑郁程度[汉密尔顿抑郁量表(hamilton depression scale，HAMD)]、神经功能缺损程度[美国国立卫生研究院卒中量表(national institutes of health stroke scale，NIHSS)]、日常生活能力[改良Barthel指数(modified barthel index，MBI)]、血清因子水平、临床疗效及不良反应发生情况。结果 治疗后，联合组MBI评分高于对照组，NIHSS、HAMD评分低于对照组(P＜0。05);联合组Hcy水平低于对照组，且NE、5-HT水平高于对照组(P＜0。05);联合组不良反应总发生率为22。50％，对照组为15。00％，两组无显著差异(P＞0。05)。联合组总治疗效率为90。00％，显著高于对照组(72。50％)(P＜0。05)。结论 盐酸度洛西汀联合枸橼酸坦度螺酮治疗可降低脑卒中后抑郁患者Hcy水平，提高5-HT、NE水平，抗抑郁效果显著。
Effectiveness of duloxetine hydrochloride combined with tandospirone citrate in treatment of post-stroke depression
Objective To investigate the effect of duloxetine hydrochloride combined with tandospirone citrate on post-stroke depression and serum 5-hydroxy tryptamine(5-HT),norepinephrine(NE),and homocysteine(Hey)levels.Methods The study population was selected from 80 patients with post-stroke depression admitted to Xuchang Central Hospital between September 2020 and September 2022,and they were randomly divided into the control group(40 ca-ses,given tandospirone citrate)and the combined group(40 cases,treated with tandospirone citrate and duloxetine hydrochloride enteric capsules based on the control group)by the numerical table method.After 4 weeks of treatment,the degree of depression[Hamilton Depression Scale(HAMD)],the degree of neurological deficit[National Institutes of Health Stroke Scale(NIHSS)],the ability to perform daily living activities[Modified Barthel Index(MBI)],the level of serum factors,the clinical efficacy,and the incidence of adverse reactions were compared between the two groups.Results After treatment,the MBI score of the combined group was higher than that of the control group,and NIHSS,HAMD scores were lower than that of the control group(P＜0.05);the Hey level of the combined group was lower than that of the control group,and the levels of NE and 5-HT were higher than that of the control group(P＜0.05);the total incidence rate of adverse reactions was 22.50％in the combined group and 15.00％in the con-trol group,and there was no significant difference between the two groups(P＞0.05);the total treatment efficiency of the combined group was 90.00％,significanty higher than that of the control group(72.50％)(P＜0.05).Conclusion Duloxetine hydrochloride combined with tandospirone citrate treatment reduces Hey levels,increases 5-HT and NE levels,and has a significant antidepressant effect in patients with post-stroke depression.
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