Clinical Study on Zhizi Houpo Decoction(栀子厚朴汤)in Treatment of Senile Patients with Post-Stroke Depression and Insomnia
Objective:To explore the clinical effect of Zhizi Houpo Decoction(栀子厚朴汤)in the treatment of senile patients with post-stroke depression and insomnia.Methods:A total of 90 senile patients with post-stroke depression and insomnia were divided into the control group and the observation group by random number table method,with 45 cases in each group.The control group received conventional western medicine treatment,and the observation group was treated with Zhizi Houpo Decoction on the basis of the treatment of the control group.Both groups were treated for 4 weeks.Traditional Chinese medicine(TCM)syndrome scores,depression and anxiety situation,cognitive function,sleep quality,polysomnography data,serum inflammatory factors and neurotransmitter levels of the two groups were compared before and after treatment,evaluate the clinical efficacy of the two groups.Results:After treatment,TCM syndrome scores in both groups were lower than those before treatment,and those of the observation group were lower than the control group(P＜0.01).The mental state assessment related scales[Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),Barthel index(BI),mini-mental state examination(MMSE),Pittsburgh sleep quality index(PSQI)]scores and national institutes of health stroke scale(NIHSS)score of the two groups were all improved compared to those before treatment,and the observation group showed better improvement than the control group(P＜0.01).After treatment,levels of the inflammatory factors[serum interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]in both groups were lower than those before treatment,and those of the observation group were lower than the control group(P＜0.01).The levels of serum neurotransmitters[5-hydroxytryptophan(5-HT),substance P(SP),neuropeptide Y(NPY),dopamine(DA),norepinephrine(NE),brain-derived neurotrophic factor(BDNF),homocysteine(HCY)]in both groups were improved compared with those before treatment,and the improvements in the observation group were better than those in the control group(P＜0.01).After treatment,the indexes of polysomnography data[total sleep time(TST),duration of rapid eye movement(REM)sleep duration,sleep efficiency(SE)and sleep latency time(SL)]in both groups were improved compared with those before treatment,and the improvements in the observation group were better than those in the control group(P＜0.01).Conclusions:Zhizi Houpo Decoction can effectively relieve the clinical symptoms,depression and anxiety state,improve cognitive function,quality of life and sleep quality of senile patients with post-stroke depression and insomnia.Its mechanism of action is related to inhibiting inflammation and improving serum neurotransmitter levels.
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