通督调神针法治疗脑卒中后抑郁:随机对照研究

Post-stroke depression treated with acupuncture therapy of dredging Governor Vessel and regulating mentality:a randomized controlled trial

目的:比较通督调神针法与西药治疗脑卒中后抑郁(PSD)的临床疗效差异。方法:将60例患者随机分为针刺组和药物组,每组30例。针刺组采用通督调神针刺法,取督脉穴百会、风府、神庭、水沟、大椎、神道为主穴,每日1次,每周6次,连续治疗4周;药物组予以口服百忧解20mg,每日1次,连续服药4周。两组患者分别于治疗前、治疗4周末运用24项汉密尔顿抑郁量表(HAMD)、改良爱丁堡-斯堪的那维亚神经功能缺损评分量表(MESSS)和日常生活活动能力量表(ADL,Barthel指数,BI)进行评分,比较两组间的疗效差异。结果:治疗4周后,针刺组HAMD评分(18.93±6.49)、MESSS评分(17.47±6.56)均低于药物组(26.07±8.66,22.43±8.26),BI评分(65.67±8.97)高于药物组(49.67±8.61),差异均具有统计学意义(P<0.01,P<0.05);针刺组抑郁症总有效率96.7%(29/30)、神经功能缺损总有效率93.3%(28/30)、日常生活活动能力总有效率100.0%(30/30),均优于药物组的83.3%(25/30)、80.0%(24/30)、80.0%(24/30),差异均有统计学意义(均P<0.05)。结论:通督调神针法不仅能改善PSD患者抑郁症状,同时能够改善PSD患者神经功能的缺损和提高日常生活活动能力,且疗效优于西药百忧解。

Objective To compare clinical efficacy differences of post-stroke depression （PSD） between acu puncture tberatly of dredging Governor Vessel and regulating mentality and western medicine. Methods Sixty cases were raiadomly divided into an acupuncture group and a medication group, 30 cases in each one. The acupuncture therapy of dredging Governor Vessel and regulating mentality was applied at Baihui （GV 20）, Fengfu （GV 16）. henting （GV 24）, Shuigou （GV 26）, Dazhui （GV 14） and Shendao （GV 11） in the acupuncture group, once a day, 6 times in a week and continuously 4 weeks were required. The medication group was treated with prozac csule. 20 nag, once a day for totally 4 weeks. The score of HAMD, MESSS and BI were respectively used to compare efficacy differences between the two groups before treatment and after four weeks of treatment. Results After four weeks of treatment, the scores of HAMI） and MESSS in the acupuncture group were （18. 93 5 ±6.49） and （17.47±6. 56）, which were remarkably decreased than （26.07±8.66） and （22.43±8.26） in the medication group, and the score of BI in the acupuncture group was （65. 67± 8. 97）, which was higher than （.2!9.67±8.61） in the medication group, and the differences were statistically significant （P〈0.05, P〈0.01）. The total effective rate of depression, neural function recover rate and daily life activities in the acupuncture group were 96.7% （29/30）, 93.3% （28/30） and 100.0% （30/30）, which were all superior to 83.3% （25/30）, 80.0% （2.1 30） and 80.0% （24/30） in the medication group （all P〈0.05）. Conclusion The acupuncture therapy of dredging vernor Vessel and regulating mentality could not only improve PSD patients＇ symptom, but also recover neural function and improve daily life activities, which has belier efficacy than western medicine.