脑卒中后抑郁症的中医证候特征

doi:10.3736/jcim20100505

Abstract

Objective

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.
Methods

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.
Results

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.
Conclusion

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.

Key words: Cerebral stroke, Depression, Qi stagnation, Blood stasis, Liver qi depression

Hui Han, Li-min Wu, Wen-ming Yang, Mei-xia Wang, Jing-jing Tang, Han Wang, Zhi-xiu Liu, Rong-zhi Liu, Ting Dong, Juan Zhang , Bo Yang, Ming-xiang Han. Characteristics of traditional Chinese medicine syndromes in post-stroke depression. Journal of Chinese Integrative Medicine, 2010, 8(5): 427-431.

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URL: http://www.jcimjournal.com/EN/10.3736/jcim20100505

http://www.jcimjournal.com/EN/Y2010/V8/I5/427

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TCM syndrome	TCM syndrome score
TCM syndrome	Cerebral stroke group (n=150)	Depression group (n=151)	PSD group (n=123)
Qi stagnation and blood stasis	10.33±3.12	12.85±2.99^**	11.55±2.54^*△
Transformation of fire due to qi stagnation	8.73±1.69	10.65±1.75^*	9.58±2.54^*
Anxiety impairing spirit	8.72±1.50	8.81±2.00	8.95±1.45
Deficiency of heart and spleen	8.88±2.54	9.13±2.33	9.02±2.48
Flaring of fire due to yin deficiency	9.45±3.34	9.77±3.13	9.78±3.55
Liver qi depression	9.22±3.27	11.92±3.22^**	11.63±2.79^**
Stagnation of phlegm and qi	9.55±3.66	9.74±2.99	9.56±3.70

TCM syndrome	Cerebral stroke group (n=150)	Depression group (n=151)	PSD group (n=123)
Qi stagnation and blood stasis	43 (28.7)	63 (41.7)**	51 (41.5)**
Transformation of fire due to qi stagnation	50 (33.3)	76 (50.2)**	56 (45.5)*
Anxiety impairing spirit	13 (8.7)	30 (19.7)**	12 (9.8)
Deficiency of heart and spleen	42 (28.0)	41 (27.2)	33 (26.8)
Flaring of fire due to yin deficiency	41 (27.3)	39 (25.8)	33 (26.8)
Liver-qi depression	76 (50.7)	94 (62.3)*	75 (61.0)*
Stagnation of phlegm and qi	10 (6.7)	10 (6.6)	8 (6.5)

TCM complicated syndrome	Cerebral stroke group (n=150)	Depression group (n=151)	PSD group (n=123)
Single syndrome	61(40.6)	32 (21.2)^*	31 (25.2)
Two syndromes	54(36.0)	60 (39.7)	40 (32.5)
Three or more syndromes	35(23.3)	59 (39.1)^*	52 (42.3)^*

TCM syndrome	Cerebral stroke group (n=150)		Depression group (n=151)		PSD group (n=123)
TCM syndrome	<60 years	≥60 years	<60 years	≥60 years	<60 years	≥60 years
Qi stagnation and blood stasis	8.95±1.35	8.48±2.45	9.69±1.88	10.66±2.76	10.45±3.02	9.76±2.46
Transformation of fire due to qi stagnation	11.55±2.44	11.27±2.97	11.48±2.87	11.77±3.35	11.35±2.21	11.29±2.97
Anxiety impairing spirit	10.77±2.00	10.17±1.98	9.91±2.20	10.15±1.95	10.35±3.12	10.37±2.52
Deficiency of heart and spleen	10.16±2.73	12.24±3.50^▲▲	11.37±2.80	11.45±2.94	12.24±3.50	11.06±3.05
Flaring of fire due to yin deficiency	9.59±3.10	9.54±3.11	10.14±2.05	9.78±2.00	9.35±3.44	10.05±3.17
Liver-qi depression	10.54±2.95	10.07±2.60	10.13±2.56	10.58±2.45	9.62±1.95	9.80±2.43
Stagnation of phlegm and qi	8.89±1.87	9.02±2.00	9.48±2.78	9.08±2.37	9.82±2.03	9.25±2.35

Characteristics of traditional Chinese medicine syndromes in post-stroke depression

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