“醒脑开窍、解郁安神”针法治疗卒中后抑郁

“Xingnao Kaiqiao,Jieyu Anshen” acupuncture in the treatment of post-stroke depression

目的观察"醒脑开窍、解郁安神"针法治疗肝气郁结型卒中后抑郁患者的临床疗效以及对血清脑源性神经营养因子(BDNF)、碱性成纤维细胞生长因子(BFGF)、胶质纤维酸性蛋白(GFAP)水平的影响。方法纳入PSD患者60例,并将其按照随机数字分组法分为治疗组和对照组各30例。对照组采用口服氟西汀治疗,治疗组采用"醒脑开窍、解郁安神"针法联合口服氟西汀治疗,两组疗程均为28 d。结果对照组临床总有效率76.67%,治疗组临床总有效率90.00%,组间比较差异有统计学意义(P<0.05)。治疗后两组患者NIHSS、HAMD评分均降低,血清BDNF、BFGF含量均升高,血清中GFAP含量降低,同组治疗前后血清BDNF、BFGF、GFAP含量比较,差异有统计学意义(P<0.01);治疗前后两组各指标差值间比较,差异有统计学意义(P<0.05)。结论 "醒脑开窍、解郁安神"针法联合氟西汀治疗PSD患者与单纯使用氟西汀治疗相比疗效更加显著。同时"醒脑开窍、解郁安神"针刺法治疗PSD可能通过增加BDNF、BFGF含量,降低GFAP含量,促进神经的可塑性,达到治疗卒中后抑郁的目的。

Objective To observe the clinical efficacy of"Xingnao Kaiqiao,Jieyu Anshen"acupuncture in the treatment of post-stroke depression patients with liver-qi stagnation and its influence on the levels of serum brain-derived neurotrophic factor(BDNF),basic fibroblast growth factor(BFGF),glial fibrillary acidic protein(GFAP).Methods 60 patients with PSD were enrolled and divided into treatment group and control group according to random number grouping,with 30 cases in each group.The control group was treated with oral fluoxetine.The treatment group was treated with"Xingnao Kaiqiao,Jieyu Anshen"acupuncture and oral fluoxetine.The treatment duration was 28 days in both groups.Results The total effective rate of the control group was 76.67%,and the total effective rate of the treatment group was 90.00%.The difference between the two groups was statistically significant(P<0.05).After treatment,the NIHSS and HAMD scores of the two groups were decreased,serum BDNF and BFGF levels were increased,serum GFAP levels were decreased.There were significant differences in serum BDNF,BFGF and GFAP levels of the two groups before and after treatment(P<0.01).There was a statistically significant difference between the two groups before and after treatment in each index(P<0.05).Conclusion"Xingnao Kaiqiao,Jieyu Anshen"acupuncture combined with fluoxetine in the treatment of PSD patients is more effective than fluoxetine alone.Mean while,"Xingnao Kaiqiao,Jieyu Anshen"acupuncture in treatment of PSD may increase the BDNF,BFGF content,reduce GFAP content,promote nerve plasticity,and achieve the purpose of treating post-stroke depression.