调督通脑法针刺治疗中风后抑郁临床研究

Clinical observation on 90 cases of depression after cerebral apoplexy treated by acupuncture regulating governor vessel tongnao

目的：评价调督通脑法针刺对中风后抑郁的临床疗效。方法将符合入选标准的90例中风后抑郁患者，按随机数字表法分2组各45例，均给予西医常规基础治疗，并指导患者进行正确的肢体功能康复训练。对照组在此基础上采用传统体针治疗，治疗组在对照组基础上加用调督通脑法针刺治疗，均连续治疗8周。采用汉密尔顿抑郁量表（Hamilton depression scale, HAMD）评估患者抑郁程度；采用中国脑卒中量表（Chinese strokescale, CSS）评估神经功能缺损程度；以 Barthel 指数（barthel index, BI）评估日常生活能力（activity of daily living, ADL）。结果治疗后，治疗组 CSS 评分[（11.38±3.94）分比（15.16±4.52）分，t＝4.229]、HAMD 评分[（6.25±3.76）分比（9.32±5.06）分，t＝3.267]均低于对照组（P＜0.01）， BI 指数评分[（69.22±7.05）分比（55.67±6.21）分，t＝9.675]高于对照组（P＜0.01）。治疗组愈显率为62.2%（28/45），对照组为33.3%（15/45），2组比较差异有统计学意义（χ2＝6.413，P＝0.011）。结论调督通脑法针刺可有效防治中风后抑郁，疗效优于其他传统体针疗法。

Objective To evaluate the clinical effect of acupuncture in the treatment of depression after stroke. Methods 90 patients with cerebral apoplexy were randomly divided into 2 groups according to the random number table, with 45 cases in each group. Patients in both groups were given routine western medicine treatment, and guided to carry out suitable limb function rehabilitation training. In addition, the control group was given traditional acupuncture treatment, while the treatment group was given the brain acupuncture treatment with tiaodu in addition to the traditional acupuncture treatment. Hamilton depression scale （HAMD） was used to assess the degree of depression, Chinese stroke scale （CSS） was used to evaluate the degree of neurological deficit, and barthel index （BI） was used to evaluate the activity of daily living （ADL）. Results After treatment, the treatment group has a lower CSS score than that of the control group （11.38 ± 3.94 vs. 15.16 ± 4.52, t=4.229）, and a lower HAMD score than that of the control group （6.25 ± 3.76 vs. 9.32 ± 5.06, t=3.267）. Meanwhile, the treatment group has a higher BI score than that of the control group （69.22 ± 7.05 vs. 55.67 ± 6.21; t=9.675, P〈0.01）. Furthermore, the treatment group has statistically significant higher cure rate than that of the control group （62.2% vs. 33.3%;χ2=6.413, P=0.011）. Conclusions Tiaodu brain acupuncture treatment of depression after stroke has obvious clinical curative effect, and is superior to other traditional acupuncture method.