孙思邈十三鬼穴联合开天门治疗脑卒中后轻中度抑郁症临床研究

Clinical Study of Mild to Moderate PSD Treated by Needling SUN 13 Ghost-Points Combined with Opeing Tianmen Manipulation

目的:观察针刺孙思邈十三鬼穴联合开天门与单纯运用开天门、单纯针刺十三鬼穴治疗脑卒中后轻中度抑郁症的临床疗效差异。方法:将114例卒中后轻中度抑郁症患者随机分为鬼穴+开天门组、孙氏鬼穴组、开天门组,各38例(孙氏鬼穴组与开天门组各脱落1例,为37例)。在常规治疗方案基础上,孙氏鬼穴组采用针刺孙思邈十三鬼穴治疗;开天门组采用开天门头部穴位推拿疗法治疗;鬼穴+开天门组予以上诉针刺鬼穴及开天门联合治疗。治疗均每日1次,1周6次,疗程共4周,对比3组治疗前后汉密尔顿抑郁量表HAMD-17、抑郁自评量表SDS评分和卒中后患者特定生存量表SS-QOL评分,并分别于治疗后1月、3月随访评定抑郁情况,比较3组临床疗效。结果:鬼穴+开天门组总有效率为89.5%(34/38),孙氏鬼穴组总有效率为64.9%(24/37),开天门组总有效率为62.2%(23/37),鬼穴+开天门组与其他两组间差异有统计学意义(P<0.05),开天门组与孙氏鬼穴组疗效差异无统计学意义(P>0.05)。治疗后鬼穴+开天门组HAMD总评分、SDS总评分均低于孙氏鬼穴组、开天门组(P<0.05),鬼穴+开天门组SS-QOL总分高于孙氏鬼穴组、开天门组(P<0.05);孙氏鬼穴组与开天门组治疗前后各项评分差异无统计学意义(P>0.05)。结论:针刺孙思邈十三鬼穴联合开天门治疗脑卒中后轻中度抑郁症在疗效方面优于单纯针刺十三鬼穴与开天门治疗,并能有效提高患者生存质量。

Objective: To observe the clinical efficacy of needling Sun 13 ghost-points combined with opening Tianmen manipulation in the treatment of mild to moderate post-stroke depression(PSD). Methods: 114 patients with mild to moderate PSD were randomly divided into the Sun 13 ghost-point group, the opening Tianmen group, and the combination group(needling Sun 13 ghost-point group + opening Tianmen), with 38 cases in each group. The treatment was once per day and six times per week, and the treatment course was four weeks. During the treatment, each group lost one case. HAMD-17 scores, SDS scores, and SS-QOL scores were compared before and after the treatment in the three groups. Depression was assessed at 1 month and 3 months after the treatment, and the clinical efficacy was compared among the three groups. Results: In terms of the total effective rate, it was 89.5%(34/38) in the combination group, it was 64.9%( 24/37 ) in the Sun 13 ghost-point group, and it was 62.2%(23/37) in the opening Tianmen group;there were statistical difference beween the combination group and the other two groups( P <0.05);and there was no statistical difference between the Sun 13 ghost-point group and the opening Tianmen group( P >0.05). The total score of HAMD-17 and the total score of SDS were lower in the combination group than those in the other two groups( P <0.05);the total score of SS-QOL was higher in the combination group than that in the other two groups( P <0.05);there were no significant differences between the other two groups( P >0.05). Conclusion: The therapy of needling Sun 13 ghost-points combined with opening Tianmen manipulation was superior to single needling Sun 13 ghost-points and single opening Tianmen manipulation in the treatment of mild to moderate post-stroke depression. The therapy can improve life quality of the patients.