中医情绪疗法结合透穴刺法对脑梗死患者的心理学评价研究

Psychological Evaluation of the Therapeutic Effect of Traditional Chinese Medicine Emotional Therapy Combined with Point Through Point Acupuncture on Cerebral Infarction

目的 探讨中医情绪疗法结合透穴刺法对脑梗死的干预价值。方法 选取2017年10月—2020年10月期间于黑龙江省中医药科学院南岗分院收治的120例脑梗死患者,按照随机数字表法分为常规组、透穴组、联合组,每组各40例。其中常规组常规对症治疗,透穴组接受透穴刺法治疗,联合组联合透穴刺法及中医情绪疗法。采用中国脑卒中临床神经功能缺损程度评分量表(CSS)及日常生活活动能力量表(Barthel指数)分别评估患者治疗前后神经功能及日常生活活动能力;采用健康调查简表(the MOS item short from health survey, SF-36)对患者日常生活能力进行评分,并分析3组患者治疗前后免疫功能及炎症因子水平[T淋巴细胞亚群CD4^(+)、CD8^(+)分布及白细胞介素-6(Interleukin 6,IL-6)、肿瘤坏死因子-α(Tumor necorosis fator-a, TNF-α)]。结果 3组患者治疗后CSS评分均较治疗前明显下降,Barthel指数均较治疗前明显升高,差异有统计学意义(P<0.05);联合组治疗后CSS评分较透穴组、常规组明显降低,Barthel指数较透穴组、常规组明显升高,差异有统计学意义(P<0.05)。3组患者治疗后生理功能、生理职能、肌体疼痛、活力、社会功能、情感功能、心理卫生、总体健康评分均较治疗前明显升高,差异有统计学意义(P<0.05),联合组治疗后活力、社会功能、情感功能、心理卫生、总体健康评分均较透穴组及常规组明显升高,差异有统计学意义(P<0.05)。3组患者治疗后CD4^(+)、CD4/CD8水平均较治疗前明显升高,CD8^(+)、IL-6、TNF-α水平均较治疗前明显降低,差异有统计学意义(P<0.05);联合组治疗后CD4^(+)、CD4/CD8水平均较透穴组及常规组明显升高,IL-6、TNF-α水平均较透穴组及常规组明显降低,差异有统计学意义(P<0.05)。结论 中医情绪疗法结合透穴刺法对改善脑梗死患者神经功能,促进患者心理健康、提高生活质量具有较好的临床应用价值。

Objective To study the intervention value of traditional Chinese medicine(TCM)emotional therapy combined with point through point acupuncture on cerebral infarction.Methods A total of 120 patients with cerebral infarction who were treated in Nangang Branch of Heilongjiang Academy of Traditional Chinese Medicine from October 2017 to October 2020 were selected and divided into conventional group, acupoint penetration group and combined group according to the random number table method, with 40 patients in each group.example.Among them, the routine group received routine symptomatic treatment, the acupoint penetration group received acupoint penetration needling, and the combination group was combined with acupoint penetration needling and TCM emotional therapy.The Chinese Stroke Clinical Neurological Impairment Rating Scale(CSS)and the Activities of Daily Living Scale(Barthel Index)were used to evaluate the neurological function and activities of daily living of the patients before and after treatment;the Health Survey Short Form(the MOS item short from health survey, SF-36)to score the daily living ability of the patients, and analyze the immune function and inflammatory factor levels[T lymphocyte subsets CD4^(+),CD8^(+)distribution and interleukin-6(Interleukin 6,IL-6),tumornecrosis factor-α(Tumor necorosis fator-a, TNF-α)].Result After treatment, the CSS scores of the three groups were significantly lower than those before treatment, and the Barthel index was significantly higher than those before treatment, and the differences were statistically significant(P<0.05).Compared with the acupoint penetration group and the routine group, the Barthel index was significantly increased, and the difference was statistically significant(P<0.05).After treatment, the scores of physiological function, physiological function, body pain, vitality, social function, emotional function, mental health and overall health of the three groups of patients were significantly higher than those before treatment, and the difference was statistically significant(P<0.05).The scores of post-vigor, social function, emotional function, mental health and overall health were significantly higher than those of the acupoint penetration group and the routine group, and the difference was statistically significant(P<0.05).After treatment, the levels of CD4^(+)and CD4/CD8 in the three groups were significantly higher than those before treatment, and the levels of CD8^(+),IL-6 and TNF-α were significantly lower than those before treatment, and the differences were statistically significant(P<0.05).The levels of CD4^(+)and CD4/CD8 in the posterior group were significantly higher than those in the acupoint-penetrating group and the conventional group, and the levels of IL-6 and TNF-α were significantly lower than those in the acupoint-penetrating group and the conventional group, and the difference was statistically significant(P<0.05).Conclusion The combination of traditional Chinese medicine emotional therapy and puncture through acupoint has a good clinical value in improving the nervous function, promoting the mental health and improving the quality of life of patients with cerebral infarction.