广西医学

卒中后抑郁（PSD）是脑卒中后常见的情感障碍并发症，严重影响患者神经功能康复与生活质量。广西壮族自治区（以下简称广西）气候湿热，居民体质湿浊，PSD的临床表现与诊疗具有地域特殊性。中西医结合疗法在改善PSD核心症状、促进功能恢复及减少西药副作用方面展现出独特优势。为规范诊疗实践，广西中西医结合学会神经病学分会组织相关学科专家制定《广西卒中后抑郁中西医结合诊疗专家共识》。该共识系统整合国内外循证医学证据、临床实践经验与广西地域特点，明确了PSD的西医诊断标准、评估工具、鉴别诊断及药物治疗方案，同时详细阐述其中医病因病机、辨证分型［尤其是痰热扰神证（岭南特色突出证型）］及中药治疗方药，重点推介针灸治疗、推拿疗法及壮医特色疗法。该共识旨在为临床医师提供一套融合中西医之长、兼具规范性与地域特色的PSD诊疗实用参考，以期提升广西地区PSD的早期识别率与临床疗效，推动民族医药的传承发展与卒中患者的全面康复。

Post⁃stroke depression (PSD) is a common emotional disorder complication after cerebral stroke, seriously affecting neurological functional recovery and quality of life in patients. Influenced by the hot and humid climate of Guangxi Zhuang Autonomous Region (hereinafter referred to as Guangxi), residents have a dampness⁃turbidity constitution, and the clinical manifestation, diagnosis and treatment of PSD possess regional characteristics. Integrated Traditional Chinese and Western Medicine therapy has demonstrated unique advantages in alleviating PSD core symptoms, promoting functional recovery, and reducing the side effects of Western Medicines. To standardize diagnostic and therapeutic practice, the Neurology Branch of Guangxi Society of Integrated Traditional Chinese and Western Medicine organized experts of related disciplines to formulate the Expert Consensus on Integrated Traditional Chinese and Western Medicine Diagnosis and Treatment of Post⁃Stroke Depression in Guangxi. It systematically integrates international and domestic evidence⁃based medical findings, clinical practical experience, and the distinctive features of the Guangxi region. The consensus clarifies the Western medical diagnostic criteria, assessment tools, differentiated diagnosis, and pharmacological treatment regimens for PSD. Concurrently, it elaborates on the etiology and pathogenesis according to Traditional Chinese Medicine, syndrome differentiation patterns (with particular emphasis on Lingnan⁃specific patterns such as phlegm⁃heat harassing the spirit), and corresponding herbal prescriptions; furthermore, acupuncture⁃moxibustion therapy, Tuina therapy and the characteristic therapies of Zhuang Medicine are mainly recommended. This consensus aims to provide clinicians with a practical reference for PSD diagnosis and treatment that combines the strengths of Traditional Chinese and Western Medicine, embodies both standardization and regional characteristics, and ultimately seeks to improve the early detection rate and clinical efficacy of PSD in Guangxi region, fostering the inheritance and development of ethnic medicine and the comprehensive rehabilitation of stroke patients.