CN113368206A - Traditional Chinese medicine composition for treating post-stroke depression - Google Patents
Traditional Chinese medicine composition for treating post-stroke depression Download PDFInfo
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Abstract
The invention discloses a traditional Chinese medicine composition for treating post-stroke depression, and belongs to the field of traditional Chinese medicine preparations. The traditional Chinese medicine composition for treating post-stroke depression is characterized by being prepared from the following raw material medicines in parts by weight: 10-20 parts of ginseng, 10-20 parts of poria cocos, 5-20 parts of polygala tenuifolia, 5-20 parts of rhizoma acori graminei, 5-15 parts of ligusticum wallichii, 5-15 parts of rhizoma atractylodis, 2-12 parts of rhizoma cyperi, 2-12 parts of radix bupleuri, 5-20 parts of spina date seed, 2-12 parts of fructus alpiniae oxyphyllae and 5-20 parts of honey-fried licorice root. The traditional Chinese medicine composition has the effects of relieving the brain and mind upset and not being full; tonify the deficiency of the heart-mind and the kidney-essence deficiency to achieve the effect of relieving the heart stagnation and achieve the purpose of treating the depression after the stroke.
Description
Technical Field
The invention relates to a traditional Chinese medicine composition for treating post-stroke depression, and belongs to the field of traditional Chinese medicine preparations.
Background
The stroke is the most common brain injury disease in the neurology department, is the first cause of disability rate and lethality rate in China, and becomes a hot spot for prevention and control of serious chronic diseases and scientific research in China. Various brain dysfunction can appear after stroke, wherein depression is the most common brain dysfunction state after stroke, and the depression aggravates cognitive dysfunction after stroke, delays the rehabilitation process after stroke, and increases the disability rate, the fatality rate and the recurrence rate of stroke. Epidemiological data show that 50% of patients with stroke are associated with depression, and up to 50% of patients with post-stroke depression will have recurrent stroke within 1 year[1]. Post-stroke depression (PSD) is one of the common and treatable complications after stroke, and is manifested as a series of depression symptoms and corresponding somatic symptom abnormalities, which, if not discovered and treated in time, will seriously affect the recovery of the neurological function of the patient after stroke, as well as the ability to return to society, increasing the disability and death risk of the patient. PSD can occur in the acute (< 1 month), intermediate (1-6 months) and recovery (> 6 months) phases following stroke, with incidence rates of 33%, 33% and 34%, respectively. A large number of studies find that PSD is closely related to poor prognosis of stroke, which may lead to not only prolonged hospitalization, neurological recovery impairment, independent disability loss, but also increased mortality. Therefore, timely identification and early intervention of PSD clinically are important for improving the prognosis and restoring social function of stroke patients[2]。
The mechanism of PSD generation is not clear, and the possible mechanisms and theories studied at present mainly include the following: (1) genetic mechanisms[3](ii) a (2) Biological mechanism[4](ii) a (3) Theory of social and psychological sciences[5](ii) a (4) Other factors[6]. PSD has been associated with both stroke brain damage and its associated cognitive impairmentThe functional disability, the decline of life quality and the like, and the social and psychological factors such as the past emotional disorder history, personality characteristics, coping style, social support and the like. Therefore, various treatment means such as psychotherapy, drug therapy and rehabilitation training should be comprehensively applied to treat PSD[7]In order to achieve the optimal therapeutic effect. At present, no effective treatment means is available in clinic, and the western medicine mainly adopts treatment medicaments such as selective 5-hydroxytryptamine reuptake inhibitors, 5-hydroxytryptamine norepinephrine reuptake inhibitors, tricyclic antidepressants and the like, but all have contraindications and adverse reactions with different degrees. Therefore, the research direction is shifted to the traditional Chinese medicine in clinic, and a more effective treatment scheme is sought. Clinical facts prove that various traditional Chinese medicine therapies have obvious effect on improving the emotional state of PSD, such as traditional Chinese medicines, acupuncture, guide massage, body building and nourishing, five-tone therapy and the like, wherein the stability and the safety of the curative effect of the traditional Chinese medicine therapy are obviously higher than those of the treatment of oral antidepressant or anxiolytic[8]. Through the prior literature reference and clinical research, the classical ancient prescription aiming at the emotion and the modern clinical self-made prescription based on the classical ancient prescription have good effects on improving the mood and intervening the depression state, and the side effect caused by long-term application of the antidepressant is obviously reduced.
[1]Simiao Wu,Bo Wu,Ming Liu,et al.Stroke in China:advances and challenges in epidemiology,prevention,and management.The Lancet Neurology,2019,18(4):394-405.
[2]Chinese experts' consensus on Wang Shao Shi, Zhou Xin Yu, Zhu Chun Yan, post-stroke depression clinical practice [ J]J. apoplexy, 2016,11(08):685-693.
[3]Tang W K,Tang N,Liao C D,et al.Serotonin receptor 2C gene polymorphism associated with post-stroke depression in Chinese patients.Genetics and Molecular Research,2013,12(2):1546-53.
[4]Determination of plasma and cerebrospinal fluid monoamine neurotransmitters [ J ] of patients with post-stroke depressive state, Lvluzhou route, Songjingui, Luhong, etc. [ J ]]China journal of psychiatric department, 2000,33:29-32.
[5]Bruggimann L,Annoni J M,Staub F,et al.Chronic posttraumatic stress symptoms after nonsevere stroke[J].Neurology,2006,66:513-516.
[6]Cojocaru G R,Popa-Wagner A,Stanciulescu E C,et al.Post-stroke depression and the aging brain[J].JMol Psychiatry,2013,1:14.
[7]The Chinese physicians Association neurologists are divided into the neuropsychological and affective disorder professional Committee, are commonly recognized by Chinese experts in post-stroke depression clinical practice, and are J.E.stroke 2016,11(8): 685) 693.
[8]Clinical study progress of Zhoushai, Zhaowei, Schlemm and post-stroke depression in traditional Chinese medicine [ J]The journal of Chinese medicine information 2020,27(03):141-144.
Disclosure of Invention
In order to solve the problems in the prior art, the invention aims to provide a pharmaceutical composition for treating post-stroke depression.
The second object of the present invention is to provide an agent for treating post-stroke depression.
A third object of the present invention is to provide a use of said pharmaceutical composition or said agent.
The purpose of the invention is realized by the following technical scheme:
a traditional Chinese medicine composition for treating post-stroke depression is prepared from the following raw material medicines in parts by weight: 10-20 parts of ginseng, 10-20 parts of poria cocos, 5-20 parts of polygala tenuifolia, 5-20 parts of rhizoma acori graminei, 5-15 parts of ligusticum wallichii, 5-15 parts of rhizoma atractylodis, 2-12 parts of rhizoma cyperi, 2-12 parts of radix bupleuri, 5-20 parts of spina date seed, 2-12 parts of fructus alpiniae oxyphyllae and 5-20 parts of honey-fried licorice root.
Preferably, the traditional Chinese medicine composition for treating post-stroke depression is prepared from the following raw material medicines in parts by weight: 12-15 parts of ginseng, 12-15 parts of poria cocos, 7-15 parts of polygala tenuifolia, 7-15 parts of rhizoma acori graminei, 6-12 parts of ligusticum wallichii, 6-12 parts of rhizoma atractylodis, 4-10 parts of rhizoma cyperi, 4-10 parts of radix bupleuri, 7-15 parts of spina date seed, 4-10 parts of fructus alpiniae oxyphyllae and 7-15 parts of honey-fried licorice root.
Further preferably, the traditional Chinese medicine composition for treating post-stroke depression is prepared from the following raw material medicines in parts by weight: 15 parts of ginseng, 15 parts of tuckahoe, 10 parts of polygala root, 10 parts of rhizoma acori graminei, 9 parts of ligusticum wallichii, 9 parts of rhizoma atractylodis, 6 parts of rhizoma cyperi, 6 parts of radix bupleuri, 10 parts of spina date seed, 6 parts of fructus alpiniae oxyphyllae and 10 parts of honey-fried licorice root.
A preparation method of a traditional Chinese medicine composition for treating post-stroke depression is obtained by uniformly mixing the traditional Chinese medicine composition.
A medicament for treating post-stroke depression, the medicament comprising an active ingredient and a pharmaceutically acceptable carrier, wherein: the active ingredient is the traditional Chinese medicine composition according to any one of the technical schemes.
Further, the dosage form of the medicine comprises one of decoction or granules.
The application of the traditional Chinese medicine composition in preparing a medicine for treating post-stroke depression.
The application of the medicine in preparing the medicine for treating post-stroke depression is provided.
Advantageous effects of the invention
1. The traditional Chinese medicine composition has the effects of relieving the brain and mind upset and not being full; tonify the deficiency of the heart-mind and the kidney-essence deficiency to achieve the effect of relieving the heart stagnation and achieve the purpose of treating the depression after the stroke.
2. The invention overcomes the difficulties of tedious operation of self-decocting traditional Chinese medicine decoction, low patient compliance and the like. The modern Chinese medicinal preparation is prepared, is convenient to prepare, convenient to take clinically, controllable in quality, suitable for industrial production and beneficial to achievement transformation.
3. Compared with the basic formula, the traditional Chinese medicine composition adds the depression-dispelling and tonifying products compared with the original medicinal materials, has the synergistic effect, can be applied to both elimination and tonifying, enhances the treatment effect on depression, and increases the treatment effect on stroke.
4. The traditional Chinese medicine composition has a remarkable treatment effect on various types of post-stroke depression.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is further described with reference to the following embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
Example 1
According to the stroke history and emotional state of a patient with post-stroke depression, the post-stroke depression is mostly attributed to the combination of stroke and depression in the traditional Chinese medicine, and the depression is a change disease of stroke, and symptoms such as irritability, amnesia, insomnia, uneasiness, anxiety, dysphoria, sadness, fear and the like appear. In the traditional Chinese medicine theory, the disease property of depression patients after stroke mostly belongs to the mixture of deficiency and excess, the traditional Chinese medicine theory is used as guidance, the integrated pharmacology and network pharmacology platform is used for big data screening in the early stage, the literature retrieval result and the long-term clinical application experience are combined, the diagnosis and the selection are performed, the basic prescription of the traditional Chinese medicine emotion disease yingsan (polygala root, ginseng, poria cocos and calamus) and the yingsan type will pellet (polygala root, ginseng, poria cocos and calamus) in Tang Dynasty famous Sun Simiao's Beijing Qianjian important prescription are selected as the basic prescription, and the other products with the functions of dispersing stagnation, eliminating stagnation and nourishing the brain are combined, and the depression after stroke is treated by the pseudo-yingcheng prescription pellet.
The original prescription of the yippee powder is from Tang Dynasty Sun Simiao 'Bei Ji Qian jin Yao Fang' and is the same as the Dingzhi pill from Tai Ping Hui Min He Ji Ju Fang, and comprises ginseng, tuckahoe, polygala tenuifolia and rhizoma acori graminei, so that the yippee powder is good for treating uneasiness and forgetfulness caused by deficiency of five internal organs, and lays a foundation for treating emotional diseases in the future. Wherein, the ginseng is the first essential medicine for reinforcing the original qi greatly, tonifying the spleen and the lung, soothing the nerves and promoting intelligence; tuckahoe has the effects of promoting diuresis and eliminating dampness, strengthening spleen and calming heart; the polygala root has the effects of restoring normal coordination between heart and kidney, soothing nerves and promoting intelligence; rhizoma Acori Graminei has effects of inducing resuscitation, eliminating phlegm, refreshing mind and improving intelligence. The whole formula mainly takes tonifying as a main part, achieves the effects of tonifying qi, nourishing the heart, tranquilizing the mind, tonifying middle-jiao and reducing diarrhea, and achieves the effects of reducing phlegm and inducing resuscitation.
The prescription of the basic prescription comprises rhizoma ligustici wallichii, rhizoma atractylodis, rhizoma cyperi, radix bupleuri, spina date seed, fructus alpiniae oxyphyllae and radix glycyrrhizae preparata. The compatibility of the medicines is that the Szechuan lovage rhizome can activate blood and promote qi circulation, and resolve visible stagnation; cang Zhu strengthens spleen and eliminates dampness, eliminates phlegm dampness; the rhizoma cyperi has the effects of soothing liver-qi stagnation and clearing heat of liver depression; radix bupleuri regulates liver and regulates qi, and reaches Shaoyang pivot machine; the spina date seed has the effects of tonifying heart and liver and nourishing liver blood to calm nerves; fructus Alpinae Oxyphyllae has effects of warming kidney and spleen, and tonifying primordial qi deficiency; prepared licorice root, radix Glycyrrhizae Praeparata, as a tonic for the spleen and the middle warmer, coordinates the effects of the other drugs in the recipe. Wherein the chuanxiong rhizome, the rhizoma atractylodis and the rhizoma cyperi have the meaning of Yueju pills, and the qi and blood and water are regulated to relieve various stagnation. The main drugs of the spina date seed, the tuckahoe, the ligusticum wallichii, the liquorice and the spina date seed decoction are combined for clearing heat and nourishing, relieving restlessness and soothing nerves. Compared with the basic prescription for eliminating phlegm and dampness, the medicine can enlarge the stagnation type and enhance the effect of resolving stagnation. The spina date seed has the effects of nourishing blood and soothing nerves, and the fructus alpiniae oxyphyllae warms and tonifies the yang of spleen and kidney, so that the effects of nourishing blood and warming yang are increased compared with the effect of tonifying qi in the basic formula. The main drugs of the spina date seed, the tuckahoe, the ligusticum wallichii, the liquorice and the intrinsic spina date seed decoction are combined to clear heat and nourish, relieve restlessness and tranquilize mind, and have slightly added heat clearing effect compared with the good tonifying effect of the basic formula. In conclusion, the whole formula takes ginseng and poria cocos as monarch drugs, mainly strengthens spleen and calms heart, takes polygala root and rhizoma acori graminei as ministers to regulate and harmonize emotion and mind, takes ligusticum wallichii, rhizoma atractylodis, rhizoma cyperi, radix bupleuri and the like as assistants to regulate and relieve depression, takes spina date seed, fructus alpiniae oxyphyllae and liquorice as guides to introduce drugs into heart, calm nerves and benefit intelligence, and plays a role in harmonizing the drugs. This disease is smooth, and can relieve the disturbance of brain and mind; by taking the effect as a basis, the traditional Chinese medicine can tonify deficiency of heart spirit malnutrition and kidney essence deficiency, and the whole formula can tonify and eliminate both, thereby achieving the effect of relieving heart and stagnation.
A traditional Chinese medicine composition for treating post-stroke depression is prepared from the following raw material medicines in parts by weight: 10 parts of ginseng, 10 parts of tuckahoe, 5 parts of polygala root, 5 parts of rhizoma acori graminei, 5 parts of ligusticum wallichii, 5 parts of rhizoma atractylodis, 2 parts of rhizoma cyperi, 2 parts of radix bupleuri, 5 parts of spina date seed, 2 parts of fructus alpiniae oxyphyllae and 5 parts of honey-fried licorice root. And then the components are mixed evenly to obtain the pharmaceutical composition for treating PSD.
Example 2
A traditional Chinese medicine composition for treating post-stroke depression is prepared from the following raw material medicines in parts by weight: 20 parts of ginseng, 20 parts of tuckahoe, 20 parts of polygala root, 20 parts of rhizoma acori graminei, 15 parts of ligusticum wallichii, 15 parts of rhizoma atractylodis, 12 parts of rhizoma cyperi, 12 parts of radix bupleuri, 20 parts of spina date seed, 12 parts of fructus alpiniae oxyphyllae and 20 parts of honey-fried licorice root. And then the components are mixed evenly to obtain the pharmaceutical composition for treating PSD.
Example 3
A traditional Chinese medicine composition for treating post-stroke depression is prepared from the following raw material medicines in parts by weight: 15 parts of ginseng, 15 parts of tuckahoe, 10 parts of polygala root, 10 parts of rhizoma acori graminei, 9 parts of ligusticum wallichii, 9 parts of rhizoma atractylodis, 6 parts of rhizoma cyperi, 6 parts of radix bupleuri, 10 parts of spina date seed, 6 parts of fructus alpiniae oxyphyllae and 10 parts of honey-fried licorice root. And then the components are mixed evenly to obtain the pharmaceutical composition for treating PSD.
Example 4
An agent for treating post-stroke depression: weighing the pharmaceutical composition described in example 1, example 2 or example 3, adding a pharmaceutically acceptable carrier when preparing a decoction or granules, and preparing the above dosage form of the pharmaceutical composition according to a conventional preparation method of the above dosage form.
Example 5
Clinical trial
Test materials: a heart-soothing depression-relieving granule formulation was prepared according to example 4.
The purpose of the test is as follows: the safety and effectiveness of the prescription of the heart-opening and depression-relieving granules for treating the post-stroke depression are evaluated.
And (3) experimental design:
3.1 inclusion criteria:
firstly, referring to the diagnosis key points of various cerebrovascular diseases revised by the Chinese medical society, the people are diagnosed with stroke;
② according to the Chinese mental disease classification and diagnosis standard-third edition (CCMD-III), the subjects diagnosed with secondary mild and moderate depression, 17 items of Hamilton depression scale (HAMD-17) score between 7 and 24 points;
③ the age of the subject is between 40 and 80 years old, and the male and the female are not limited;
fourthly, the patient is diagnosed as depression for the first time after stroke (the patient is diagnosed as PSD within 6 months after stroke);
no psychiatric or family history before stroke;
sixthly, the normal consciousness can be matched with various examinations, no aphasia or serious cognitive disorder exists, and mental state examination (MMSE score) >17 points;
seventhly, the liver and kidney function is checked to be normal;
and can provide voluntary signed informed consent.
3.2 exclusion criteria:
(ii) subjects diagnosed with primary or secondary major depression having a score of >24 for HAMD-17, a history of depressive disorder or major trauma, major depression or any other major psychiatric disorder within 1 year;
② taking part in any other clinical test or taking hormone and mental medicine within the last 1 month;
③ aphasia and severe cognitive dysfunction (MMSE score <17 points);
unstable vital signs, poor control of basic diseases, or serious systemic diseases such as heart disease, malignant tumor, renal and hepatic insufficiency;
fifthly, the medicine is allergic to the components of the granules for relieving the heart and the depression;
sixthly, pregnant women or women in lactation period;
seventhly, magnetic resonance contraindications;
and refusing to sign an informed consent form of the study.
The 40 subjects in the group were divided into placebo, western (fosiltin) treatment, basal (happy ending) and formula granules according to the invention, each group containing 10 subjects, on a randomized, controlled basis.
Standard of therapeutic effect
4.1 subjective rating scale: hamilton Depression Scale (HAMD-17); stroke Scale (NIHSS) national institute of health; depression self-rating scale (SDS); the traditional Chinese medicine depression scale; modified Barthel Index (MBI); side reaction scale (TESS); daily living capacity scale (ADL).
4.2 Objective evaluation index (specificity): hypersensitivity C-reactive protein and blood homocysteine.
All subjects receive the detection of the two clinical efficacy evaluation indexes before treatment, after 4 weeks of treatment, and 1 month and 2 months after finishing treatment respectively, and the four detection results are collated and counted for analysis and comparison.
The granules for relieving the heart and the depression have the advantages of relieving the brain and mind disorder and having a poor emotion; tonify deficiency of heart-mind and kidney essence deficiency to achieve the effect of relieving heart stagnation, and can effectively treat depression after stroke.
Specific cases are exemplified by:
1. wangzhi, male, 72 years old, the first hospitalization time was 2021 years, 6 months and 2 days, language disorder did not appear before 2 days, right lower limb movement disorder did not appear, as shown by head CT: no bleeding was observed and cerebral infarction was diagnosed. Data measured by the anxiety self-rating scale was 48 and data measured by the depression self-rating scale was 41, and post-stroke depression was diagnosed. Prescription of doctor: 15 parts of ginseng, 15 parts of poria cocos, 10 parts of polygala tenuifolia, 10 parts of rhizoma acori graminei, 9 parts of ligusticum wallichii, 9 parts of rhizoma atractylodis, 6 parts of rhizoma cyperi, 6 parts of radix bupleuri, 10 parts of spina date seeds, 6 parts of fructus alpiniae oxyphyllae and 10 parts of radix glycyrrhizae preparata, and the decoction is prepared into a decoction for oral administration, one dose is taken every day, the decoction is taken at 8 days in the evening, the decoction is continuously taken for two weeks and is discharged; the test was repeated at 23 days 6 months 2021, and the data was 28 on the anxiety self-rating scale and 25 on the depression self-rating scale. As can be seen from the examination results, the patient has reduced depression after stroke by taking the Chinese medicinal composition.
2. The first hospitalization time of 2021 years for a woman of 64 years is 6 months and 7 days, the right limb weakness is not caused before 1 month, the symptoms are gradually aggravated, and the emergency treatment is performed in 5 months and 4 days, as shown by first CT: lacunar cerebral infarction occurs frequently, the department of neurology is admitted and hospitalized for 5 months and 6 days, and the patient is discharged after improvement. At present, patients still have symptoms of weakness, numbness and the like of the right side of the body, and are treated by the department of the inventor in the recovery period of cerebral infarction. Data measured by the anxiety self-rating scale was 55, data measured by the depression self-rating scale was 51, and post-stroke depression was diagnosed. Prescription of doctor: 15 parts of ginseng, 15 parts of tuckahoe, 10 parts of polygala root, 10 parts of rhizoma acori graminei, 9 parts of ligusticum wallichii, 9 parts of rhizoma atractylodis, 6 parts of rhizoma cyperi, 6 parts of radix bupleuri, 10 parts of spina date seed, 6 parts of fructus alpiniae oxyphyllae and 10 parts of honey-fried licorice root, and the decoction is prepared into a decoction for oral administration, one dose is taken every day, and the decoction is taken continuously after the decoction is taken in the morning of 9 days; the test was repeated at 23 days 6 months 2021, and the data was 48 on the anxiety self-rating scale and 38 on the depression self-rating scale. As can be seen from the examination results, the patient has reduced depression after stroke by taking the Chinese medicinal composition.
Claims (7)
1. The traditional Chinese medicine composition for treating post-stroke depression is characterized by being prepared from the following raw material medicines in parts by weight: 10-20 parts of ginseng, 10-20 parts of poria cocos, 5-20 parts of polygala tenuifolia, 5-20 parts of rhizoma acori graminei, 5-15 parts of ligusticum wallichii, 5-15 parts of rhizoma atractylodis, 2-12 parts of rhizoma cyperi, 2-12 parts of radix bupleuri, 5-20 parts of spina date seed, 2-12 parts of fructus alpiniae oxyphyllae and 5-20 parts of honey-fried licorice root.
2. The traditional Chinese medicine composition for treating post-stroke depression according to claim 1, which is prepared from the following raw material medicines in parts by weight: 15 parts of ginseng, 15 parts of tuckahoe, 10 parts of polygala root, 10 parts of rhizoma acori graminei, 9 parts of ligusticum wallichii, 9 parts of rhizoma atractylodis, 6 parts of rhizoma cyperi, 6 parts of radix bupleuri, 10 parts of spina date seed, 6 parts of fructus alpiniae oxyphyllae and 10 parts of honey-fried licorice root.
3. A preparation method of a traditional Chinese medicine composition for treating post-stroke depression is characterized in that the traditional Chinese medicine composition is prepared by uniformly mixing the traditional Chinese medicine composition of claim 1 or 2.
4. A medicament for treating post-stroke depression, which comprises an active ingredient and a pharmaceutically acceptable carrier, wherein the active ingredient is the traditional Chinese medicine composition of claim 1 or 2.
5. The medicament of claim 4, wherein: the dosage form of the medicine comprises one of decoction or granules.
6. Use of the Chinese medicinal composition of claim 1 or 2 for the preparation of a medicament for the treatment of post-stroke depression.
7. Use of a medicament according to claim 4 or 5 for the manufacture of a medicament for the treatment of post-stroke depression.
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| CN115531504A (en) * | 2022-10-12 | 2022-12-30 | 上海市静安区中医医院 | Traditional Chinese medicine composition for treating post-stroke depression and application thereof |
| CN116370571A (en) * | 2023-02-15 | 2023-07-04 | 上海市第七人民医院(上海中医药大学附属第七人民医院) | Traditional Chinese medicine composition, compound decoction, and preparation method and application thereof |
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