调神疏肝针法结合百忧解改善卒中后抑郁症患者抑郁症状和神经功能的临床研究

Clinical Study of Tiaoshen Shugan Acupuncture Combined with Fluoxetine in Alleviating Depression Severity and Improving Neurological Function of PSD Patients

目的:观察调神疏肝针法配合百忧解对卒中后抑郁症患者的抑郁症状和神经功能影响。方法:将62例患者随机分为观察组和对照组,每组31例。对照组口服百忧解(20 mg)治疗,每日1次,连续治疗4周。观察组在口服百忧解(20 mg/d)的基础上进行调神疏肝针法治疗,取穴百会、四神聪、太冲、三阴交与肝俞,每次治疗30 min,1次/d,每周5次,治疗4周;两组患者分别于治疗前、治疗2周后、治疗4周后各时间点观察两组患者的24项汉密尔顿抑郁量表(HAMD)评分和美国国立卫生研究院卒中量表(NIHSS)评分。结果:治疗2周后,两组的HAMD评分与治疗前比较,差异具有统计学意义(P<0.01),NIHSS评分显著低于治疗前,差异具有统计学意义(P<0.01);观察组的HAMD评分、NIHSS评分显著低于对照组,差异具有统计学意义(P<0.05或P<0.01)。治疗4周后,观察组HAMD评分、NIHSS评分显著低于2周前,差异具有统计学意义(P<0.05或P<0.01),对照组HAMD评分、NIHSS评分显著低于2周前,差异具有统计学意义(P<0.01);观察组NIHSS评分显著低于对照组,差异具有统计学意义(P<0.01)。结论:调神疏肝针法结合百忧解对改善卒中后抑郁患者的抑郁程度和神经功能有较好的疗效。

Objective:To observe the effects of Tiaoshen Shugan acupuncture combined with Fluoxetine on depression symptoms and neurological function in the patients with post-stroke depression(PSD).Methods:62 PSD patients were randomly divided into the observation group and the control group,with 31 patients in each group.The control group was treated with Fluoxetine(20mg,once a day for 4 weeks);on which basis,the observation group was also treated with Tiaoshen Shugan acupuncture(once per day,5 times per week for 4 weeks).The points chosen in the observation group were Baihui(DU20),Sishencong(EX-HN1),Taichong(LR3),Sanyinjiao(SP6)and Ganshu(BL18).The scores of Hamilton Anxiety Scale(HAMD)and National Institutes of Health Stroke Scale(NIHSS)were recorded before the treatment,2 weeks after the treatment and 4 weeks after the treatment in the two groups.Results:The scores of HAMD and NIHSS were significantly lower after 2 weeks of the treatment than those before the treatment in the two groups(P<0.01);the scores of HAMD and NIHSS were significantly lower in observation group than those in control group after two weeks of the treatment(P<0.05,P<0.01).The scores of HAMD and NIHSS were significantly lower after four weeks of the treatment than those before the treatment in the observation group and the control group(P<0.05,P<0.01).The score of NIHSS was significant lower in the observation group than that in the control group after 4 weeks of the treatment(P<0.01).Conclusion:Tiaoshen Shugan acupuncture combined with Fluoxetine is effective in alleviating depression severity and improving neurological function of PSD patients.