针灸治疗脑卒中后抑郁研究进展

Research Progress of Acupuncture and Moxibustion in the Treatment of Post-Stroke Depression

针灸治疗脑卒中后抑郁的方法主要有:单纯针刺疗法、针药结合疗法、针刺联合特色疗法、艾灸疗法。目前,关于针灸治疗脑卒中后抑郁的研究还存在一些不足:①临床报道的样本量均偏小,缺少多中心、大样本的随机对照研究,研究结果可能存在一定的偏倚。②西药对照组的设立不统一,不同的抗抑郁西药作用靶点不同,疗效和安全性亦存在差异,作为对照给深入研究带来较大的困惑。③辨证论治是中医特色,但不少临床研究对该病未进行分型治疗。④大多数临床研究的观察时间为4～8周,缺少长期随访的结果。因此,在今后的研究中,应更加完善实验设计方案,扩大样本量,延长观察随访时间,使用具有充分循证医学证据的西药作为对照,同时结合中医辨证论治,将分型和治疗方案进一步细化,逐步形成较完备的诊疗方案。

The main methods of acupuncture and moxibustion for post-stroke depression are simple acupuncture,combination of acupuncture and medicine,combination of acupuncture and characteristic therapy,and moxibustion therapy. At present,there are still some problems in the study of acupuncture and moxibustion in the treatment of post-stroke depression:①The sample size of clinical reports is small,and there is a lack of multi-center,large-sample randomized controlled studies. The results may be biased.②The establishment of Western medicine control group is not uniform,different antidepressant drugs have different targets,and their efficacy and safety are also different. As a control group,it brings great confusion to further study.③Treatment based on syndrome differentiation is the characteristic of TCM,but many clinical studies have not classified the disease.④ Most clinical studies have been observed for 4 to 8 weeks,lacking long-term follow-up results. Therefore,in the future research,we should improve the experimental design,expand the sample size,prolong the observation and follow-up time,use Western medicine with sufficient medical evidence as the control subjects,and combine the syndrome differentiation and treatment of TCM,further refine the classification and treatment plan,and gradually form a more complete diagnosis and treatment design.