目的 探讨乌灵胶囊联合圣约翰草提取物片治疗脑梗死后抑郁的临床效果。方法 选取2016年6月—2018年6月白水县医院收治的脑梗死后抑郁患者78例，随机分成对照组（39例）和治疗组（39例）。对照组口服圣约翰草提取物片，1片/次，3次/d。治疗组在对照组基础上口服乌灵胶囊，3粒/次，3次/d。两组均治疗8周。观察两组患者临床疗效，同时比较治疗前后两组患者抑郁相关量表评分、单胺类神经递质和匹兹堡睡眠质量指数（PSQI）评分。结果 治疗后，对照组和治疗组临床有效率分别为79.5%和94.9%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组17项汉密尔顿抑郁量表（HDRS-17）和患者健康问卷-9项（PHQ-9）评分均显著下降（P<0.05），简易精神状态检查（MMSE）评分显著升高（P<0.05），且治疗后治疗组HDRS-17、PHQ-9和MMSE评分明显优于对照组（P<0.05）。治疗后，两组神经递质多巴胺（DA）和去甲肾上腺素（NE）血浆浓度均显著升高（P<0.05），且治疗组DA和NE血浆浓度比对照组升高更明显（P<0.05）。治疗后，两组PSQI 6个维度评分及总分较治疗前均显著降低（P<0.05），且治疗组比对照组下降更明显（P<0.05）。结论 乌灵胶囊联合圣约翰草提取物片治疗脑梗死后抑郁，可有效控制临床症状，改善认知功能，提高睡眠质量。

Objective To investigate the clinical efficacy of Wuling Capsules combined with St. John's Wort Extract Tablets in treatment of depression after cerebral infarction. Methods Patients (78 cases) with depression after cerebral infarction in Baishui County Hospital from June 2016 to June 2018 were randomly divided into control (39 cases) and treatment (39 cases) groups. Patients in the control group were po administered with St. John's Wort Extract Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Wuling Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the depression-related scale scores, monoamine neurotransmitter, PSQI scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 79.5% and 94.9% respectively, and there were differences between two groups (P<0.05). After treatment, the HDRS-17 and PHQ-9 scores in two groups were significantly decreased (P<0.05), but the MMSE scores in two groups was significantly increased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the plasma concentration of DA and NE in two groups was significantly increased (P<0.05), and which in the treatment group was significantly higher than that in the control group (P<0.05). After treatment, the 6 indexes scores of PSQI scores and total scores in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Wuling Capsules combined with St. John's Wort Extract Tablets in treatment of depression after cerebral infarction can effectively control depressive symptoms, improve cognitive function and the quality of sleep.