针刺不同组穴治疗中风后抑郁临床研究

Clinical Study on Acupuncture at Different Groups of Acupoints for Post-stroke Depression

目的通过对针刺不同组穴治疗中风后抑郁(post-stroke depression,PSD)的临床疗效进行评价,选出最佳穴位处方。方法将108例PSD患者随机分为3组,内关组、太冲组和百会组,每组36例,每日针刺1次,每星期5次,3星期为1个疗程。疗程结束后比较3组临床疗效,并对3组治疗前后汉密尔顿抑郁量表评分(HAMD)、神经功能缺损量表评分(NIHSS)、生活质量量表评分(QOL)进行统计学分析。结果内关组、太冲组、百会组治疗中风后抑郁的有效率分别为72.2%、75.0%、86.1%,3组间疗效比较差异有统计学意义(P<0.05);3组治疗前后HAMD评分、NIHSS评分、QOL评分比较差异均有统计学意义(P<0.01);组间比较,NIHSS评分、QOL评分差异均无统计学意义(P>0.05)。结论 3组在改善患者抑郁症状、神经功能缺损、生活质量方面都有一定疗效,但百会组在改善患者抑郁症状方面疗效优于内关组和太冲组;3组在改善患者神经功能缺损及生活质量方面疗效相当。

Objective To select the optimal acupoints formula by evaluating the efficacy of different groups of acupoints in the treatment of post-stroke depression （PSD） with acupuncture. Method Totally 108 PSD patients were randomized into 3 groups, i.e. Neiguan （PC6） group, Taichong （LR3） group, and Baihui （GV20） group, 36 cases each. The acupuncture treatment was given once a day, 5 sessions a week, 3 weeks as a treatment course. The clinical efficacies were compared among the 3 groups after the intervention. The 3 groups were evaluated by the Hamilton Depression Scale （HAMD）, National Institute of Health Stroke Scale （NIHSS）, and Quality of Life Scale （QOL） before and after the treatment, and the results were statistically analyzed. Result The effective rates were respectively 72.2%, 75.0%, and 86.1%in Neiguan group, Taichong group, and Baihui group, and the inter-group differences were statistically significant （P〈0.05）; the HAMD, NIHSS, and QOL scores were significantly changed after the intervention in the 3 groups （P〈0.01）;the inter-group differences in the NIHSS and QOL scores were statistically insignificant （P〉0.05）. Conclusion The three groups of acupoints are effective in improving the depression symptoms, neural defect and QOL, while Baihui group can produce a more significant efficacy in improving the depression symptoms compared to Neiguan and Taichong groups;the effects in improving neural defect and QOL are equivalent among the 3 groups of acupoints.