针刺联合经颅直流电刺激治疗卒中后轻中度抑郁的临床研究

Clinical Study of Acupuncture Combined with Transcranial Direct Current Stimulation in the Treatment of Mild to Moderate Depression after Stroke

目的:观察针刺联合经颅直流电刺激(transcranial Direct Current Stimulation,tDCS)治疗卒中后轻中度抑郁的临床疗效和安全性。方法:选取2021年12月—2023年1月安徽省中医院针灸康复一科住院的60例卒中后轻中度抑郁患者,随机分为对照组30例,观察组30例。2组均给予常规基础治疗,对照组采用tDCS治疗,观察组采用针刺结合tDCS治疗,每周5次,共治疗4周。比较治疗前后2组汉密尔顿抑郁量表评分((Hamilton Depression Scale,HAMD)、美国国立卫生研究院神经功能缺损评分(National Institutes of Health Stroke Scale,NIHSS)、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PQSI)评分及改良Barthel指数(Modified Barthel Index,MBI)评分的变化情况,评判2组临床疗效差异;同时观察2组治疗期间的不良反应。结果:治疗后2组患者HAMD、NIHSS、PQSI、MBI评分较治疗前均有统计学意义(P<0.05),且观察组较对照组HAMD、NIHSS、PQSI、MBI评分更优(P<0.05)。观察组治疗的总有效率优于对照组(P<0.05)。治疗过程中2组均无严重不良反应的发生。结论:针刺联合tDCS可改善患者忧郁情绪、神经功能缺损情况及睡眠质量,对患者的日常生活能力也有所提升,临床疗效优于单纯使用经颅直流电刺激治疗且治疗安全性较高。

Objective:To observe the clinical efficacy and safety of acupuncture combined with transcranial Direct Current Stimulation(tDCS)in the treatment of mild to moderate depression after stroke.Methods:60 patients with mild to moderate post-stroke depression who were hospitalized in the Acupuncture Rehabilitation Department of Anhui Provincial Hospital of Traditional Chinese Medicine from December 2021 to January 2023 were selected and randomly divided into a control group of 30 cases and an observation group of 30 cases.Both groups were given routine basic treatment,the control group was treated with tDCS,and the observation group was treated with acupuncture combined with tDCS,5 times a week for a total of 4 weeks.Compare the Hamilton Depression Scale(HAMD),National Institutes of Health Stroke Scale(NIHSS),and Pittsburgh Sleep Quality Index(PQSI)scores of the two groups before and after treatment.)score and Modified Barthel Index(MBI)score changes to evaluate the difference in clinical efficacy between the 2 groups;at the same time,the adverse reactions of the 2 groups during treatment were observed.Results:HAMD,NIHSS,PQSI,and MBI scores of the 2 groups of patients after treatment There was statistical significance compared with before treatment(P<0.05),and the observation group had better HAMD,NIHSS,PQSI,and MBI scores than the control group(P<0.05).The total effective rate of treatment in the observation group was better than that of the control group(P<0.05).No serious adverse reactions occurred in either group during the treatment.Conclusion:Acupuncture combined with tDCS can improve patients’depression,neurological deficits and sleep quality,and also improve patients’daily living abilities,with clinical efficacy better than Transcranial direct current stimulation alone is a safe treatment.