目的 探討鹽酸帕羅西汀聯(lián)合天丹通絡(luò)膠囊治療腦卒中后抑郁癥（PSD）的臨床療效。方法 將納入PSD組82例患者隨機分為治療組42例和對照組40例。在常規(guī)治療的基礎(chǔ)上，對照組給予鹽酸帕羅西汀片口服，20 mg/次，1次/d，早餐后服用。治療組在對照組的基礎(chǔ)上聯(lián)合使用天丹通絡(luò)膠囊，2.0 g/次，3次/d。兩組療程均為6周。治療前后以漢密爾頓抑郁量表（HAMD）評定抑郁程度，以中國卒中量表（CSS）和日常生活能力量表（ADL）分別評定神經(jīng)功能缺損程度和日常生活能力。結(jié)果 治療2、4、6周后，兩組的HAMD量表值均低于治療前，差異有統(tǒng)計學(xué)意義（P<0.05）；治療組的的總有效率高于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。治療6周后，治療組的CSS評分較治療前顯著下降，ADL評分較治療前顯著上升，但治療組ADL評分明顯高于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 鹽酸帕羅西汀聯(lián)合天丹通絡(luò)膠囊治療PSD比單純使用鹽酸帕羅西汀起效快，且能促進神經(jīng)功能恢復(fù)，是值得臨床推廣的一種治療方法。

Objective To investigate the clinical efficacy of paroxetine hydrochloride combined with Tiandan Tongluo Capsules in the treatment of post stroke depression (PSD).Methods Patients with PSD were 82 cases which were randomly divided into treatment (42 cases) and control (40 cases) groups. On the basis of routine therapy, the patients in the control group were po administered with Paroxetine Hydrochloride Tablets, 20 mg/time after breakfast daily. While the patients in the treatment group were administered combined with Tiandantongluo Capsules every time 2.0 g/time, for three times daily on the basis of control group. The patients in the both groups were treated for 6 weeks. Hamilton depression rating scale (HAMD) was used to evaluate the severity of depression before and after the treatment. Chinese stroke scale (CSS) and daily life ability scale (ADL) respectively were used to evaluate the degree of neurologic deficits and daily life ability. Results In 2, 4, and 6 weeks after the treatment, HAMD values were lower than that in the same group before the treatment, and the difference was statistically significant (P < 0.05). The total effective rate of the treatment group was higher than that in the control group at the same time with significant differences (P< 0.05). Six weeks after the treatment, the CSS scores were lower than those in the same group before the treatment, and ADL scores were higher than those in the same group before the treatment. And there were the significant differences between the two groups (P< 0.05). Conclusion Paroxetine hydrochloride combined with TiandanTongluo Capsules in the treatment of PSD takes the action faster than only using paroxetine hydrochloride, and it can promote neural functional recovery. It is worth of clinic application.