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Medicine early intervention in acute stroke on concurrent depressive effects and ~ 1H-MRS studies

Author: HuangZuo
Tutor: ChenMei
School: Zhejiang University of Traditional Chinese Medicine
Course: Internal Medicine
Keywords: Stroke Depression Traditional Chinese Medicine Early Intervention Proton Magnetic Resonance Spectroscopy Prefrontal white matter
CLC: R277.7
Type: Master's thesis
Year: 2009
Downloads: 57
Quote: 0
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Abstract


Objective: To observe the Ditan Huayu Decoction on early intervention in acute stroke patients with depressive effects, as well as neurological deficits and restore the role of daily living; and explore post-stroke proton magnetic resonance spectroscopy (~ 1H-MRS) analysis and post-stroke depression (PSD) in the early correlation. Methods: 102 cases meet the requirements of acute stroke patients were randomly divided into intervention group of 62 patients and a control group of 40 patients. Intervention component 2 weeks group, 34 patients and 28 patients in January, in the conventional treatment based on early treatment with Chinese medicine. Hamilton Depression Scale (HAMD) seventeen editions evaluate depression and changes occur, the U.S. National Institutes of Health Stroke Scale (NIHSS) evaluation of changes in nerve function, activities of daily living (ADL) scale Barthel Index ( BI) evaluation on the ability of patients' daily lives. All patients in the hospital in stable condition within 3 days after the initial evaluation of the scale and incidence of two weeks respectively, in January and March when repeated follow-up evaluation. According to the incidence of depression and changes in each of the above scale scores compared to determine efficacy. In the above cases, 25 cases were randomly selected in early stroke underwent bilateral prefrontal white matter and the hippocampus ~ 1H-MRS scans. According to follow-up results, depression (PSD) group without depression (NPSD) group were 13 cases and 12 cases; normal control group of 20 patients, the frontal lobe and hippocampus ~ 1H-MRS scan all 10 cases. Analysis of various parts of the metabolite N-acetyl aspartate (NAA) / creatine (cr), choline (Cho) / Cr and myo-inositol (mI) / Cr ratio changes. Results: 1. TCM intervention group than the control group PSD (including severe) incidence rate decreased, which group intervention in January occurred in three months when depression was significantly lower than the control group (P <0.0125), reach statistical significance; 2 . the follow-up point, HAMD, NIHSS, Barthel index scale score intervention group than the control group improved significantly. The intervention group in January more significant differences (P <0.05 or P <0.01), and in three months when all respects superior to two weeks or more group (P <0.05 or P <0.01); 3. Compared with control group, PSD group of patients with bilateral prefrontal white matter and the hippocampus NAA / Cr ratio was significantly lower (P <0.05 or P <0.01), and Cho / Cr ratios increased, and in the left prefrontal cortex and the hippocampus was significantly (P <0.01 ); compared with NPSD, PSD group left Cho / Cr and left hippocampus increased NAA / Cr decreased significantly different (P <0.05). Conclusions: 1. Stroke a higher incidence of depression. The Ditan Huayu Decoction early intervention can reduce depression after stroke, including the incidence of severe depression; 2. Ditan Huayu Decoction early intervention can significantly improve patients' depression, neurological impairment after stroke and recovery activities of daily living have a significant effect; 3 proton magnetic resonance spectroscopy can reflect in vivo brain metabolite changes; 4 after acute stroke, bilateral prefrontal white matter, hippocampus lower NAA / Cr and high Cho / Cr ratios PSD indicates likely happened afterwards, whether concurrent post-stroke depression has a certain value judgments.

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