针药并用对卒中后运动性失语患者抑郁状态的影响

Effect of Acupuncture Combined with Medication on Depressive State in Patients with Post-stroke Motor Aphasia

目的观察针药并用治疗卒中后运动性失语患者抑郁状态的临床疗效。方法将60例卒中后运动性失语患者按随机数字表法随机分为针药联合组(30例)和药物组(30例)。两组患者均接受卒中常规治疗,药物组在常规治疗基础上口服盐酸氟西汀胶囊,针药联合组在药物组治疗基础上采用头针联合电针。观察两组患者治疗前后以及随访时卒中后失语患者抑郁问卷(医院版)(SADQ-H)评分、汉语标准失语症检查法(CRRCAE)评分、神经功能缺损评分表(NIHSS)评分变化。结果两组患者治疗后及随访时SADQ-H、CRRCAE、NIHSS评分均低于治疗前(P<0.05);组间比较除CCRCAE评分阅读、复述差异无统计学意义(P>0.05),其余各项CCRCAE评分及SADQ-H、NIHSS评分,药物组均显著低于针药联合组,差异具有统计学意义(P<0.01)。结论针药并用治疗卒中后运动性失语患者抑郁状态效果显著,优于单纯盐酸氟西汀治疗。

Objective To observe the clinical efficacy of acupuncture combined with medication in treating depressive state in patients with post-stroke motor aphasia.Method Sixty patients with post-stroke motor aphasia were randomly allocated to an acupuncture-medication integrated group(30 cases)and a medication group(30 cases)using the random number table method.The two groups of patients all received conventional treatment for stroke.In addition,the medication group was given oral administration of Fluoxetine hydrochloride capsules,while the acupuncture-medication integrated group was given scalp acupuncture plus electroacupuncture(EA).The scores of Stroke Aphasic Depression Questionnaire-Hospital version(SADQ-H),Chinese Rehabilitation Research Center Aphasia Examination(CRRCAE)and National Institute of Health Stroke Scale(NIHSS)were observed before and after treatment and at follow-up.Result Compared with the pre-treatment,the SADQ-H,CRRCAE and NIHSS scores decreased after treatment and at follow-up(P<0.05);there were no significant between-group differences in the reading and retelling scores in CRRCAE(P>0.05),while the rest CCRCAE component scores and the scores of SADQ-H and NIHSS were significantly lower in the medication group than in the acupuncture-medication integrated group(P<0.01).Conclusion Acupuncture combined with medication can produce significant efficacy in treating depressive state in patients with post-stroke motor aphasia,better than using Fluoxetine hydrochloride alone.