针药并用干预中风后抑郁症对日常生活自理能力的影响

Effect of Combined Use of Acupuncture and Medicine on the Activities of Daily Living in the Treatment of Post-stroke Depression

目的探讨针刺配合中药(疏肝健脾法)干预中风后抑郁症(post-stroke depression,PSD)同时对患者日常生活自理能力的影响。方法将128例中风后抑郁症患者随机分为中药组、针刺组、针药组、西药组,每组32例。分别予中药、针刺、中药配合针刺及氟西汀胶囊治疗,各组疗程均为30 d,治疗前后评定汉密尔顿抑郁量表(HAMD)、改良Barthel指数评定量表。观察不同方案对PSD近期疗效以及对患者日常生活自理能力的影响。结果四组各有30例纳入结果分析,治疗后HAMD量表评分降低(P<0.01),改良Barthel指数评分提高(P<0.01),组间治疗后比较,针药组与其他三组积分差异均有统计学意义(P<0.05,P<0.01),中药组、针刺组和西药组组间积分两两比较差异均无统计学意义(P>0.05)。结论各组治疗方案均能改善PSD患者抑郁症状,提高日常生活活动能力,且针刺配合中药具有协同增效作用。

Objective To investigate the effect of acupuncture plus Chinese herbal medicine （soothing the liver and strengthening the spleen） on the activities of daily living in the treatment of post-stroke depression （PSD） patients. Method One hundred and twenty-eight patients with post-stroke depression were randomly allocated to Chinese herbal medicine, acupuncture, acupuncture plus medicine and western drug groups, 32 cases each. They were treated with Chinese herbal medicine for soothing the liver and strengthening the spleen, acupuncture, Chinese herbal medicine for soothing the liver and strengthening the spleen plus acupuncture and fluoxetine capsules, respectively. The course of treatment consisted of 30 days in all the groups. An evaluation was made using the Hamilton Depression Scale （HAMD） and the Modified Barthel Index before and after treatment. The short-term effects of different protocols on PSD and their effects on the patients＇ activities of daily living were evaluated. Result The results were analyzed in 30 cases from each of the 4 groups. The HAMD score decreased （P〈0.01） and the Modified Barthel Index increased （P 〈0.01） after treatment. A post-treatment between-group comparison showed statistically significant differences in the scores between the acupuncture plus medicine group and the other 3 groups （P〈0.05,P〈0.01） and no statistically significant differences in the scores between any two of the Chinese herbal medicine, acupuncture and western drug groups （P〉0.05）. Conclusion All the protocols can improve the symptoms and the activities of daily living in PSD patients. Acupuncture and Chinese herbal medicine have a synergistic effect.