针刺结合西医常规疗法治疗脑卒中后抑郁临床研究

Clinical study on treatment of poststroke depression by acupuncture combined with conventional therapy of western medicine

目的 评价针刺结合西医常规疗法治疗脑卒中后抑郁（post-stroke depression, PSD）的疗效。方法 将符合入选标准的60例患者采用随机数字表法将患者分为2组，每组30例。针刺组采用针刺结合西医常规疗法治疗，非针刺组采用安慰针刺结合西医常规疗法治疗。2组均治疗４周。采用汉密尔顿抑郁量表（Hamilton Depression Rating Scale, HAMD）评价患者的抑郁状态，观察2组患者治疗期间不良反应发生情况。结果 针刺组第1周[（27.1±6.1）分比（30.8±5.0）分，t＝-5.532]、第2周[（22.6±6.3）分比（26.2±4.7）分，t＝2.744]、第4周[（15.8±7.3）分比（20.7±5.2）分，t＝3.570]、第8周[（9.9±6.2）分比（15.6±5.7）分，t＝6.154]HAMD评分均低于非针刺组（P＜0.01）。治疗期间，针刺组出现失眠2例、恶心呕吐2例，不良反应发生率为13.3%（4/30），非针刺组分别为9例、8例，不良反应发生率为56.7%（17/30），2组不良反应发生率比较，差异有统计学意义（χ2＝10.550，P＝0.001）。结论 针刺结合西医常规疗法可改善PSD患者的抑郁状态，降低不良反应，提高患者生活质量。

Objective To evaluate the curative effect of acupuncture combined with conventional therapy for the treatment of post-stroke depression （PSD）. Methods Sixty patients were divided into two groups according to the computer. Acupuncture group was treated with acupuncture combined with conventional therapy of western medicine. Non-acupuncture group was treated with sham acupuncture combined with conventional therapy. Both groups were treated for 4 weeks. The patients was evaluated using the Hamilton depression rating for scale （HAMD）. Adverse reactions during treatment were assessed by the Treatment emergent Symptom Scale （TESS）. Results The HAMD score at the first week （27.1 ± 6.1 vs. 30.8 ± 5.0, t=-5.532）, the second week （26.6 ± 6.3 vs. 15.8 ± 7.3, t=2.744）, the 4th week （15.8 ± 7.3 vs. 20.7 ± 5.2, t=3.570）, and the 8th week （9.9 ± 6.2 vs. 15.6 ± 5.7, t=6.154） in the acupuncture group were lower than those in the non-acupuncture group （P〈0.01）. During the treatment, 2 cases of insommia occurred in acupuncture group, 8 cases of insommia occurred in nonacupuncture group, 2 cases of nausea and vomiting occurred in acupuncture group, 9 cases of nausea and vomiting occurred in nonacupuncture group（χ2=10.550, P=0.001）. Conclusions Acupuncture combined with conventional therapy can improve the depressive state of PSD patients, reduce the adverse reactions and improve the quality of life of patients.