针药联合治疗脑卒中后抑郁的临床疗效观察

Clinical Observation on the Treatment of Post-Stroke Depression with Acupuncture and Medication

目的:观察针药联合治疗脑卒中后抑郁的临床疗效。方法:将符合纳入标准的72例脑卒中后抑郁患者按区组随机化方法分为治疗组和对照组,各36例,所有患者均给予基础病常规和康复治疗。对照组口服盐酸氟西汀片加中药活血疏肝解郁汤加减,治疗组在对照组基础上联用针灸治疗。共治疗8周。比较分析两组患者治疗各阶段神经功能缺损评分量表(NIHSS)、汉密尔顿抑郁量表(HAMD)和中医证候量表评分情况。结果:两组治疗8周后,NIHSS、HAMD和中医证候评分较治疗前比较有统计学意义(P<0.05,P<0.01);治疗4周后,治疗组NIHSS、HAMD和中医证候评分较治疗前比较有统计学意义(P<0.05),对照组HIHSS评分较治疗前比较有统计学意义(P<0.05)。两组HAMD有效率、中医证候有效率比较,差异有统计学意义(P<0.05)。结论:治疗后两组患者抑郁症状均得到改善,但针药联合治疗更具优势。

Objective:To observe the clinical efficacy of acupuncture combined with medication in the treatment of post-stroke depression(PSD).Methods:72 patients with post-stroke depression were randomly divided into the treatment group(n=36)and the control group(n=36).The control group was treated with Fluoxetine Hydrochloride and Huoxue Shugan Jieyu Decoction;on which basis,the treatment group was also treated with acupuncture.At the same time,basic treatment and rehabilitation treatment were also applied to both groups.The scores of neurological deficit scale(NIHSS),Hamilton depression scale(HAMD)and TCM symptom scale were analyzed at the end of four weeks of treatment and at the end of eights weeks of treatment.Results:There were statistical differences in the scores of NHISS and HAMD between before and after the treatment in the two groups after eight weeks of treatment(P<0.05,P<0.01).After four weeks of treatment,the differences in the scores of NIHSS and HAMD were seen between before and after the treatment in the treatment group(P<0.05);the control group only showed statistical difference in the NIHSS scores between before and after the treatment(P<0.05).There were statistical differences in the HAMD scores and TCM symptom scores between the two groups after the treatment(P<0.05).Conclusion:The clinical symptoms of post-stroke depression were improved in the two groups after the treatment,but acupuncture combined with medication shows better curative effect.