目的:探讨解郁安神颗粒合盐酸帕罗西汀片治疗缺血性脑中风后抑郁症的疗效以及对血清白细胞介素(IL)-6,IL-23,肿瘤坏死因子-α(TNF-α),去甲肾上腺素(NE)和5-羟色胺(5-HT)水平的影响。方法:筛选94例缺血性脑中风后抑郁症患者,按数字表法将所有病例随机分为观察组48例和对照组46例;两组患者根据《中国脑卒中康复治疗指南》给予常规治疗;对照组口服盐酸帕罗西汀片,初始剂量20 mg·d-1,每周以10 mg递增,最大剂量不超过40 mg·d-1。观察组在对照组治疗的基础上给予解郁安神颗粒,5 g/次,2次/d,冲服。两组患者均连续治疗6周。比较两组患者汉密尔顿抑郁(HAMD)量表评分,HAMD量表因子评分及临床疗效;检测两组患者血清IL-6,IL-23,TNF-α,NE和5-HT水平。结果:观察组治疗后3周和6周HAMD量表评分分别低于对照组同时点(P<0.01);观察组治疗后HAMD量表各因子评分明显低于对照组(P<0.01);观察组的临床总有效率为91.67%,高于对照组的71.74%(P<0.05);治疗后观察组血清IL-6,IL-23和TNF-α水平均低于对照组,NE和5-HT水平均高于对照组,比较差异有统计学意义(P<0.01)。结论:解郁安神颗粒合盐酸帕罗西汀片能提高缺血性脑中风后抑郁症的治疗,其治疗效果可能与下调患者血清IL-6,IL-23,TNF-α及上调NE,5-HT水平有关。 Objective: To investigate the curative effect of Jieyu Anshen Granule combined with paroxetine hydrochloride tablet on depression after ischemic cerebral apoplexy, and the effect on serum interleukin (IL) -6, IL-23, tumor necrosis factor-α (TNF- Norepinephrine (NE) and serotonin (5-HT) levels. Methods: Ninety-four patients with depression after ischemic stroke were enrolled. All patients were randomly divided into observation group (n = 48) and control group (n = 46) according to the digital table method. Two groups were given routine treatment according to “Guidelines for Chinese Stroke Rehabilitation Treatment” . The control group was treated with Paroxetine Hydrochloride orally. The initial dose was 20 mg · d-1, which was increased 10 mg weekly and the maximum dose was no more than 40 mg · d-1. Observation group in the control group on the basis of treatment given Jieyu Anshen particles, 5 g / time, 2 times / d, blunt. Two groups of patients were treated for 6 weeks. The Hamilton Depression Rating Scale (HAMD), HAMD Scale Score and clinical efficacy were compared between the two groups. Serum levels of IL-6, IL-23, TNF-α, NE and 5-HT were measured in both groups. Results: The scores of HAMD in observation group were lower than those in control group at 3 weeks and 6 weeks respectively (P <0.01). The score of HAMD in observation group was significantly lower than that of control group (P <0.01) The clinical total effective rate was 91.67%, which was higher than that of the control group (71.74%, P <0.05). The levels of IL-6, IL-23 and TNF-α in the observation group were lower than those in the control group HT levels were higher than the control group, the difference was statistically significant (P <0.01). Conclusion: The treatment of paroxetine hydrochloride tablets can improve depression after ischemic stroke, and its therapeutic effect may be related to down-regulation of serum IL-6, IL-23, TNF-α and upregulation of NE, 5-HT Horizontal related.