四花穴麦粒灸结合疏肝泻火汤治疗气郁化火型中风后抑郁临床研究

Clinical Study on the Treatment of Post-Stroke Depression with Depressed Qi Transforming into Fire Syndrome with Wheat-Grain-Sized Cone Moxibustion at Sihua Points Combined with Decoction for Soothing the Liver and Purging Fire

目的:观察四花穴麦粒灸结合疏肝泻火汤治疗气郁化火型中风后抑郁的临床疗效。方法:将96例中风后抑郁患者按照随机数字表法分为对照组和观察组,每组各48例。对照组给予氟西汀治疗,观察组在对照组治疗的基础上给予四花穴麦粒灸结合疏肝泻火汤治疗。比较两组患者治疗前后中医证候积分、神经功能[血清5-羟色胺(5-hydroxy tryptamin,5-HT)、S100-β、美国国立卫生院神经功能缺损评分(national institutes of health neurological deficit score,NIH-SS)]、抑郁及日常生活状态[汉密尔顿焦虑量表(hamilton depression scale,HAMD)评分、日常生活活动能力量表(activity of daily living,ADL)评分]及不良反应发生情况。结果:两组患者治疗后口角歪斜、胸胁胀满、头晕耳鸣及舌红苔黄评分低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后5-HT高于本组治疗前,S100-β、NIHSS评分低于本组治疗前,观察组治疗后5-HT高于对照组,S100-β、NIHSS评分低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后ADL评分高于本组治疗前,HAMD评分低于本组治疗前,观察组治疗后ADL评分高于对照组,HAMD评分低于对照组,差异具有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:四花穴麦粒灸结合疏肝泻火汤治疗气郁化火型中风后抑郁,可改善患者神经功能、抑郁状态,提高日常生活能力。

Objective:To observe the clinical efficacy of wheat-grain-sized cone moxibustion at Sihua points(BL19 and BL 17)combined with Decoction for Soothing the Liver and Purging Fire on post-stroke depression with depressed qi transforming into fire syndrome.Methods:A total of 96 patients with post-stroke depression were randomly divided into the control group and the obser-vation group,with 48 cases in each group.The control group was treated with fluoxetine,while the observation group was treated with wheat-grain-sized cone moxibustion at Sihua points combined with Decoction for Soothing the Liver and Purging Fire on post-stroke depression on the basis of the treatment of the control group.The TCM syndrome scores,neurological function[including se-rum 5-hydroxytryptamine(5-HT)and S100-βand the national institutes of health neurological deficit score(NIHSS)],depres-sion and daily living status[Hamilton depression scale(HAMD)score,activity of daily living(ADL)score]and the occurrence of adverse reactions before and after treatment were compared between the two groups.Results:The scores of mouth angle devia-tion,chest and flank fullness,dizziness,tinnitus and red tongue and yellow fur in the two groups after treatment were lower than those in the group before treatment,and the above indexes of the observation group were lower than those in the control group after treatment,and all the differences were statistically significant(P<0.05).After treatment,5-HT in the two groups was higher than that of the same group before treatment,while S100-βand NIHSS were lower than those of the same group before treatment,and 5-HT in the observation group was higher than that in the control group after treatment,while S100-βand NIHSS were lower than those of the control group,and all the differences were statistically significant(P<0.05).After treatment,the ADL score of the two groups was higher than that of the same group before treatment,while the HAMD score was lower than that of the same group before treatment,and the ADL score of the observation group was higher than that of the control group after treatment,while the HAMD score was lower than that of the control group,and all the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Wheat-grain-sized cone moxibustion at Sihua points combined with Decoction for Soothing the Liver and Purging Fire on post-stroke depression with depressed qi transforming into fire syndrome can improve patients'neurological function,depression state and daily living ability.