针灸并用对卒中后抑郁患者心率变异性的影响

Effect of Acupuncture Combined with Moxibustion on Heart Rate Variability in Patients with Post-stroke Depression

目的观察针灸并用对卒中后抑郁患者心率变异性(HRV)的影响。方法将120例患者分为对照组(n=60)和治疗组(n=60)。两组均给予口服百忧解及针刺治疗,治疗组配合艾灸疗法,比较两组治疗前后汉密尔顿抑郁量表(HAMD)17项评分及HRV改变。结果治疗后,治疗组HAMD评分低于对照组,减分率高于对照组(P<0.05);两组24 h正常R-R间期标准差(SDNN)、24 h每5分钟平均正常R-R间期标准差(SDANN)均较治疗前增加(P<0.05),治疗组大于对照组(P<0.05);24 h相邻R-R间期差值的均方根(RMSSD)、24 h相邻R-R间期差值>50 ms的百分数(PNN50)较治疗前降低(P<0.05),治疗组小于对照组(P<0.05);两组低频功率(LF)、高频功率(HF)及LF/HF均大于治疗前(P<0.05),治疗组大于对照组(P<0.05)。结论针灸结合较单纯针刺能更好地调整卒中后抑郁患者自主神经功能,改善其抑郁状态。

Objective To observe the effect of acupuncture combined with moxibustion on heart rate variability（HRV） in patients with post-stroke depression. Methods 120 patients were divided into control group（n=60） and treatment group（n=60）. Both groups took fluoxetine and accepted acupuncture therapy, and the treatment group accepted moxibustion additionally. Hamilton Depression Rating Scale-17（HAMD-17） and the change of HRV were compared before and after treatment. Results The score of HAMD was lower, and the reductive ratio was higher in the treatment group than in the control group（P〈0.05）. The standard deviation of the mean of qualified normal sinus interval（SDNN） and standard deviation of sequential five-minute R-R interval means（SDANN） increased in both groups after treatment（P〈0.05）, and were higher in the treatment group than in the control group（P〈0.05）. The root mean square differences of successive R-R intervals（RMSSD） and percentage of differences between adjacent normal sinus intervals greater than 50 ms（PNN50） decreased in both groups after treatment（P〈0.05）, and were lower in the treatment group than in the control group（P〈0.05）. The low frequency（LF）, high frequency（HF） and LF/HF were higher in both groups after treatment（P〈0.05）, and were higher in the treatment group than in the control group（P〈0.05）. Conclusion Acupuncture combined with moxibustion therapy can better adjust the function of autonomic nerve and reduce depression in patients with post-stroke depression.