目的 探討解郁丸聯(lián)合度洛西汀治療卒中后抑郁的臨床療效。方法 選取南陽南石醫(yī)院2016年1月-2018年12月收取的卒中后抑郁患者136例，隨機分為對照組和治療組，每組各68例。對照組口服鹽酸度洛西汀腸溶片，起始劑量40 mg/d，1周后調(diào)整為60 mg/d。治療組在對照組基礎(chǔ)上口服解郁丸，4 g/次，3次/d。兩組療程均為8周。觀察兩組患者臨床療效，同時比較治療前后兩組患者漢密爾頓抑郁量表（HAMD）評分，及血清去甲腎上腺素（NE）、5-羥色胺（5-HT）、P物質(zhì)（SP）和神經(jīng)肽Y（NPY）水平。結(jié)果 治療后，對照組和治療組臨床有效率分別為76.47%和91.18%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者HAMD評分顯著低于治療前（P<0.05），且治療組明顯高于對照組（P<0.05）。治療后，兩組患者血清5-HT、NE和NPY水平均顯著高于治療前（P<0.05），而SP水平顯著降低（P<0.05），且治療組患者血清5-HT、NE、NPY和SP水平明顯好于對照組（P<0.05）。結(jié)論 解郁丸聯(lián)合度洛西汀治療卒中后抑郁患者，可顯著升高血清5-HT、NE、NPY水平和降低SP水平，療效顯著，安全性好。

Objective To observe the efficacy of Jieyu Pills combined with duloxetine in treatment of post-stroke depression. Methods Patients (136 cases) with post-stroke depression in Nanshi Hospital of Nanyang from January 2016 to December 2018 were randomly divided into control and treatment groups, and each group had 68 cases. Patients in the control group were po administered with Duloxetine Hydrochloride Enteric-coated Tablets, the initial dose was 40 mg/d, and then adjusted to 60 mg/d after one week. Patients in the treatment group were po administered with Jieyu Pills on the basis of the control group, 4 g/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the HAMD score, the serum level of NE, 5-HT, SP and NPY in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 76.47% and 91.18% respectively, and there were differences between two groups (P<0.05). After treatment, the HAMD score in two groups was significantly decreased (P<0.05), and which in the treatment group was significantly lower than that in the control group (P<0.05). After treatment, the serum level of NE, 5-HT, and NPY in two groups was significantly increased (P<0.05), but the SP level was significantly decreased (P<0.05), and the serum level of NE, 5-HT, SP, and NPY in the treatment group was significantly better than that in the control group (P<0.05). Conclusion Jieyu Pills combined with duloxetine in treatment of post-stroke depression can significantly increase the serum level of NE, 5-HT and NPY, reduce the SP level, which has significant curative effect and good safety.

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