Treating Poststroke Depression from the Perspective of Depression Caused by Stagnation
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摘要: 卒中后抑郁是脑卒中后常见的并发症,对脑卒中患者的预后产生深远影响。介绍了因瘀致郁理论渊源,因瘀致郁病机内涵主要包括两点:脑络瘀阻,神机失用;心神失养,郁证乃生。并对因瘀致郁与卒中后抑郁的现代生物学机制进行探讨,认为卒中后抑郁病理机制与低脑血流量、血小板功能障碍、内皮功能损伤、脂代谢异常、炎症反应等因素密切相关。从形神共治的角度提出卒中后抑郁的治疗以活血解郁为主,不仅要对卒中本身进行治疗,还要重视因病而导致的心理障碍的识别与干预。Abstract: Poststroke depression is a common complication after stroke, which has a profound impact on the prognosis of stroke patients. The article introduced the origin of the depression caused by stagnation theory. The pathogenesis connotation of the theory mainly includes two points: cerebral collateral stasis leading to vital activity dysfunction; nourishment deprivation of heart spirit leading to depression. The article also explored the modern biological mechanisms of depression caused by stagnation as well as poststroke depression. It is believed that the pathological mechanism of poststroke depression is closely related to factors such as low cerebral blood flow, platelet dysfunction, endothelial dysfunction, abnormal lipid metabolism, and inflammatory response. From the perspective of the joint treatment of body and spirit, it is proposed that the treatment of poststroke depression should mainly focus on promoting blood circulation and relieving depression. It is not only necessary to treat the stroke itself, but also to pay attention to the identification and intervention of psychological disorders caused by the disease.
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