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Journal of Chinese Integrative Medicine ›› 2010, Vol. 8 ›› Issue (5): 427-431.doi: 10.3736/jcim20100505

Special Issue: Traditional Chinese Medicine

• Original Clinical Research • Previous Articles     Next Articles

Characteristics of traditional Chinese medicine syndromes in post-stroke depression

 Hui Hana,b, Li-min Wuc, Wen-ming Yanga, Mei-xia Wanga, Jing-jing Tanga, Han Wanga, Zhi-xiu Liua, Rong-zhi Liua, Ting Donga, Juan Zhanga, Bo Yanga, Ming-xiang Hana,d   

  1. a Department of Neurology, First Affiliated Hospital, Anhui University of Traditional Chinese Medicine, Hefei 230031, Anhui Province, China
    b Department of Geriatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100029, China
    c Medical Research Center, Anhui Provincial Hospital, Hefei 230001, Anhui Province, China
    d School of Professional and Continuing Education, University of Hong Kong, Hong Kong, China
  • Received:2009-08-31 Accepted:2010-02-20 Online:2010-05-20 Published:2010-05-15
  • Contact: Hui Han E-mail:chinaxyh@mail.hf.ah.cn

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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

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TCM syndrome TCM syndrome score
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

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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)

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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)*

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TCM syndrome Cerebral stroke group (n=150) Depression group (n=151) PSD group (n=123)
<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
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