脏时五音相调法针刺治疗脑卒中后抑郁疗效观察

Observation on the Therapeutic Effect of Zangshi Wuyin Coordination Acupuncture on Post-Stroke Depression

目的探讨脏时五音相调法针刺法治疗脑卒中后继发抑郁(Post stroke depression,PSD)的临床疗效。方法选取2018年9月—2020年2月期间于佛山市第一人民医院同济康复医院住院及门诊的脑卒中后抑郁患者90例,采用随机数字表法随机分为对照1组、对照2组和治疗组,每组各30例。3组患者均给予基础治疗,对照1组给予氟西汀,对照2组采用常规针刺,治疗组在常规针刺基础上给予脏时五音相调法针刺(子午流注针法配合五音疗法)治疗。3组患者均治疗4周后评价疗效。结果3组患者治疗后汉密尔顿抑郁量表(Hamilton depression scale,HAMD)17项、抑郁自评量表(Self-rating depression scale,SDS)、美国国立卫生研究院卒中量表(NIHStrokeScale,NIHSS)评分均较治疗前降低,差异有统计学意义(P<0.05);3组患者治疗后HAMD、SDS、NIHSS评分差值比较:治疗组高于对照1组、对照2组,差异有统计学意义(P<0.05),对照2组高于对照1组,差异有统计学意义(P<0.05)。治疗组临床疗效高于对照1组,差异有统计学意义(P<0.05)。结论脏时五音相调法针刺治疗脑卒中后抑郁对于减轻患者抑郁状态及神经功能的改善明显优于氟西汀和常规针刺治疗,费用低,易于基层医院开展。

Objective To explore the clinical efficacy of Zangshi Wuyin coordination acupuncture in the treatment of post-stroke depression.Methods A total of 90 patients with post-stroke depression who were hospitalized and outpatients of Tongji Rehabilitation Hospital of Foshan First People′s Hospital from September 2018 to February 2020 were selected and randomly divided into control group 1,control group 2 and treatment group,with 30 patients in each group.Patients in the three groups were given basic treatment,control group 1 was given fluoxetine,control group 2 was given routine acupuncture,treatment group was given Zangshi Wuyin coordination acupuncture(meridian flow acupuncture combined with Wuyin therapy)on the basis of routine acupuncture.The efficacy was evaluated after 4 weeks of treatment in all three groups.Results The scores of 17 items of Hamilton depression scale(Hamilton depression scale,HAMD),self-rating depression scale(SDS),and National Institutes of Health Stroke Scale(NIHStrokeScale,NIHSS)scores in three groups after treatment were lower than before,the difference was statistically significant(P<0.05).The difference of HAMD,SDS and NIHSS scores after treatment in the three groups was compared:the treatment group was higher than the control group 1 and the control group 2,and the difference was statistically significant(P<0.05),the control group 2 was higher than the control group 1,the difference was statistically significant(P<0.05).The clinical efficacy of the treatment group was higher than that of the control group 1,and the difference was statistically significant(P<0.05).Conclusion Zangshi Wuyin coordination acupuncture treatment of post-stroke depression is significantly better than fluoxetine and conventional acupuncture treatment in alleviating depression and improving neurological function,with low cost and easy to be carried out in primary hospitals.