情志护理联合针刺干预中风后抑郁50例临床观察

Clinical Observation of 50 Cases of Post Stroke Depression Psychological Nursing Intervention Combined with Acupuncture

[目的]观察情志护理联合针刺干预中风后抑郁疗效。[方法]对50例住院患者情志护理联合针刺。针刺:遵医嘱针刺,取百会(双侧)、四神聪、神庭(双侧)、内关(双侧)、神门(双侧)、三阴交(双侧),患者仰卧位,一次性针灸针(0.32mm×25mm^50mm)刺入穴位,平补平泻,得气后留针30min。情志护理,情志相胜法:讲述幽默故事、回忆愉快经历等营造轻松欢快病房氛围,使患者心情愉悦,遗忘抑郁等情绪;移情易性法:了解患者兴趣爱好,鼓励患者积极参与兴趣活动,改善心境;五音疗法:给患者听节奏舒缓的,优雅而抒情且愉快、选用格调欢乐、兴奋、舒畅、节奏明快活泼的曲目,缓解抑郁情绪,30min/次,2次/d。连续干预7d为1疗程。观测临床症状、HAMD评分、不良反应。连续护理2疗程(14d),判定疗效。[结果]痊愈38例,好转8例,无效4例,总有效率92.00%。HAMD评分护理前(22.75±4.36)分,护理后(10.51±2.19)(P<0.01)。[结论]情志护理联合针刺疗法护理中风后抑郁,疗效满意,具有研究价值。

[Objective] To observe the curative effect of depression psychological nursing combined with acupuncture intervention after stroke. [Methods] 50 cases of hospitalized patients with psychological nursing combined with acupuncture. Acupuncture： acupuncture doctor, Baihui （bilateral）, Sishencong, Shenting （bilateral）, Neiguan （bilateral）, Shenmen （bilateral）, Sanyinjiao （bilateral）, the patient supine, disposable acupuncture needle （0.32mm × 25mm-50mm） into acupuncture, reinforcing reducing, too after the gas needle 30min. Emotional nursing, emotional method： humorous story, recall the pleasant experience to create a relaxed and cheerful atmosphere of the mood ward, patients, forgetting depression; empathy easy method： understanding of patient interest, encourage patients to actively participate in the activities of interest, improve the mood; fifth therapy to the patient to listen to soothing rhythm, elegant and lyric and pleasant, with joy, excitement, comfortable style, rhythm and lively songs, alleviate depression, 30 min/times, 2 times/d. Continuous intervention with 10d for 1 courses. Clinical symptoms, HAMD score and adverse reactions were observed. Continuous nursing 2 course of treatment （14d）, to determine the effect [Results] In the recovery of 38 cases, improved in 8 cases, invalid in 4 cases, the total effective rate of 92%. HAMD score before nursing （22.75 ±4.36） points, after nursing （10.51± 2.19） （P〈0.01）. [Conclusion] The effect of emotional nursing care combined with acupuncture therapy of depression after stroke, satisfied with research value.