耳针联合自拟中药汤剂口服治疗中风后抑郁临床研究

Clinical Study on Auricular Acupuncture Combined with Oral Administration of Self-made Traditional Chinese Medicine Decoction in the Treatment of Post-stroke Depression

目的观察耳针联合自拟中药汤剂口服治疗中风后抑郁患者抑郁情绪及神经功能的临床效果。方法选择张家口市中医院2018年7月—2020年12月收治的98例中风后抑郁患者,随机分为对照组49例,治疗组49例,对照组患者使用常规西医方法治疗,治疗组在对照组基础上使用耳针联合口服自拟中药汤剂治疗,治疗后比较两组患者的临床疗效及不良反应发生率;治疗前及治疗后2、4、8周,比较两组患者汉密尔顿抑郁评分量表(HAMD)评分、美国国立卫生研究院卒中量表(NIHSS)评分、匹兹堡睡眠质量指数(PSQI)及阿森斯失眠量表(AIS)评分;治疗前后比较两组患者世界卫生组织生存质量测定量表汉化版(WHOQOL-BREF)评分。结果治疗组治疗总有效率为95.92%,高于对照组的81.63%(P<0.05);治疗前,两组患者HAMD评分比较差异无统计学意义(P>0.05),治疗不同时间后治疗组患者HAMD评分均低于对照组(P<0.05);治疗前,两组患者NIHSS评分比较差异无统计学意义(P>0.05),治疗不同时间后治疗组患者NIHSS评分均低于对照组(P<0.05);治疗前,两组患者PSQI及AIS评分比较差异无统计学意义(P>0.05),治疗后,治疗组PSQI及AIS评分均低于对照组(P<0.05);治疗前,两组患者心理、生理、环境、社会评分及WHOQOL-BREF总分比较差异无统计学意义(P>0.05),治疗后,治疗组患者心理、生理、环境、社会评分及WHOQOL-BREF总分均高于对照组(P<0.05);治疗后,治疗组并发症的总发生率低于对照组(P<0.05)。结论耳针联合自拟中药汤剂治疗中风后抑郁患者有很好的临床疗效,可缓解其抑郁情绪,促进神经功能恢复,改善预后,提高生活质量。

Objective To study the clinical effect of auricular acupuncture combined with oral administration of self-made traditional Chinese medicine decoction on depression and neurological function in patients with post-stroke depression.Methods 98 patients with post-stroke depression admitted to Zhangjiakou hospital of traditional Chinese medicine were selected between July 2018 and December 2020and were divided into control group(49 cases)and treatment group(49 cases)by the random number table method.The control group was treated with conventional Western medicine,and the treatment group was given auricular acupuncture combined with oral administration of self-made traditional Chinese medicine decoction on the basis of western medicine in the control group.After treatment,the clinical efficacy,incidence rate of adverse reactions of the two groups of patients were compared.Before treatment and at 2,4 and 8 weeks after treatment,the Hamilton Depression Scale(HAMD)score,the National Institutes of Health Stroke Scale(NIHSS)score,the scores of Pittsburgh Sleep Quality Index(PSQI)and Athens Insomnia Scale(AIS)were compared between the two groups.The scores of World Health Organization Quality of Life Scale(WHOQOL-BREF)of the two groups were compared before and after treatment.Results The total effective rate of treatment in treatment group was higher than that in control group(95.92%vs 81.63%)(P<0.05).Before treatment,there was no significant difference in HAMD score between the two groups(P>0.05).After treatment for different periods of time,the HAMD score of treatment group was lower than that of control group(P<0.05).Before treatment,the NIHSS score was not significantly different in the two groups of patients(P>0.05),and the NIHSS score of treatment group was lower than that of control group at different time points after treatment(P<0.05).Before treatment,there were no significant differences in the scores of PSQI and AIS between the two groups of patients(P>0.05).After treatment,the scores of PSQI and AIS in treatment group were lower than those in control group(P<0.05).There was no statistical differences in scores of psychology,physiology,environment and society and total score between the two groups(P>0.05).After treatment,the scores of psychology,physiology,environment and society and total score of WHOQOL-BREF of patients in treatment group were higher than those in control group(P<0.05).After treatment,the total incidence rate of complications in treatment group was lower than that in control group(P<0.05).Conclusion Auricular acupuncture combined with self-made traditional Chinese medicine decoction has a good clinical efficacy in treating patients with poststroke depression,and it can relieve the depression,promote the recovery of neurological function,improve the prognosis,and enhance the quality of life.