中医针药结合心理干预治疗脑卒中后抑郁症临床观察

Clinical observation of needle-medicine therapy combined with psychological therapy in treatment of post-stroke depression

目的探讨中医针药与心理干预相结合治疗脑卒中后抑郁症临床效果及安全性。方法选取2010年1月至2014年2月该院收治的脑卒中后抑郁症患者130例,以随机数字表抽样方法分为对照组和观察组,各65例。对照组患者给予术后常规心理干预治疗,观察组患者在此基础上加用中医针药综合治疗。比较两组患者近期疗效、治疗前后汉密尔顿抑郁量表(HAMD)评分、日常生活活动能力量表(ADL)评分、美国国立卫生研究院卒中量表(NIHSS)、简易智能量表(MESS)评分及治疗后不良反应量表(TESS)评分等。结果观察组患者治疗总有效率[93.85%(61/65)]高于对照组[75.38%(49/65)],差异有统计学意义(P<0.05);两组患者治疗后HAMD、ADL、NIHSS及MESS评分较治疗前有改善,且观察组改善程度显著优于对照组,差异均有统计学意义(P<0.05);观察组患者治疗后28、42 d TESS评分显著低于对照组,差异均有统计学意义(P<0.05)。结论中医针药与心理疗法相结合治疗脑卒中后抑郁症可显著改善抑郁症状,提高患者生活质量,有助于促进神经功能损伤修复和降低不良反应发生风险,疗效及安全性优于单纯心理干预疗法。

Objective To approach clinical effects and safety of needle-medicine therapy combined with psychological therapy in treatment of post-stroke depression. Methods A total of 130 patients with post-stroke depression of this hospital from January 2010 to February 2014 were chosen and divided into the control group （65 patients） who were treated with conventional psychological therapy and the observation group（65 patients） with needle and medicine therapy on the basis of the control group according to random number table sampling. The short-term efficacy,scores of HAMD,ADL,NIHSS,MESS and TESS before and after treatment of both groups were compared. Results The overall response rate in the observation group was higher than that of the control group[93.85%（61/65）vs. 75.38%（49/65）],whose difference had statistical significance（P〈0.05）. The scores of HAMD, ADL,NIHSS and MESS after the treatment of the two groups were significantly better than those before the treatment. The differ-ence had statistical significance（P〈0.05）. The TESS scores on the 28 d and 42 d after the treatment in the observation group was significantly better than those of the control group,whose difference was statistically significant（P〈0.05）. Conclusion The needle-medicine therapy combined with psychological therapy in the treatment of post-stroke depression may efficiently release depres-sive symptoms,improve quality of life,promote neurological functional recovery process and reduce the risk of adverse reaction.