穴位艾灸联合氟西汀治疗肝郁脾虚型脑卒中后抑郁的疗效观察

Efficacy observation of acupoint moxibustion combined with fluoxetine in treating post-stroke depression of liver depression and spleen deficiency type

目的 探究穴位艾灸联合氟西汀治疗肝郁脾虚型脑卒中后抑郁的疗效。方法 80例肝郁脾虚型脑卒中后抑郁患者作为研究对象,将其按照随机分配法分为研究组和对照组,每组40例。对照组患者给予口服氟西汀治疗,研究组患者在对照组的基础上加用穴位艾灸治疗。对比两组患者的神经递质[脑源性神经营养因子(BDNF)、去甲肾上腺素(NE)、5-羟色胺(5-HT)]水平、美国国立卫生研究院卒中量表(NIHSS)评分、汉密尔顿抑郁量表(HAMD)评分、疗效、不良反应发生率。结果 研究组患者的脑源性神经营养因子为(42.69±1.64)ng/ml、去甲肾上腺素为(10.29±1.26)μg/L、5-羟色胺为(140.25±2.61)ng/ml;对照组患者的脑源性神经营养因子为(36.51±2.61)ng/ml、去甲肾上腺素为(8.13±1.27)μg/L、5-羟色胺为(111.81±3.52)ng/ml。研究组患者的脑源性神经营养因子、去甲肾上腺素、5-羟色胺高于对照组,差异具有统计学意义(P<0.05)。研究组患者的NIHSS评分(2.89±1.02)分明显低于对照组的(4.26±1.21)分,差异具有统计学意义(P<0.05)。研究组患者的HAMD评分为(8.24±1.02)分,明显低于对照组的(13.26±1.62)分,差异具有统计学意义(P<0.05)。研究组患者的治疗总有效率为95.00%,明显高于对照组的80.00%,差异具有统计学意义(P<0.05)。研究组患者的不良反应发生率为7.50%,明显低于对照组的27.50%,差异具有统计学意义(P<0.05)。结论 对于肝郁脾虚型脑卒中后抑郁患者而言,采用穴位艾灸联合氟西汀治疗疗效更佳,能够有效地降低不良反应发生率,值得在临床上广泛运用。

Objective To explore the efficacy of acupuncture moxibustion and fluoxetine in treating post-stroke depression of liver depression and spleen deficiency type.Methods 80 patients with post-stroke depression of liver depression and spleen deficiency type were selected and randomly divided into a study group and a control group,with 40 cases in each group.Patients in the control group were treated with oral fluoxetine,and patients in the study group were treated with acupuncture moxibustion on the basis of the control group.Patients in both groups were compared in terms of neurotransmitter[brain-derived neurotrophic factor(BDNF),norepinephrine(NE),5-hydroxytryptamine(5-HT)]level,National Institutes of Health Stroke Scale(NIHSS)score,Hamilton Depression Scale(HAMD)score,therapeutic efficacy and the incidence of adverse reactions.Results In the study group,the brain-derived neurotrophic factor was(42.69±1.64)ng/ml,the norepinephrine was(10.29±1.26)μg/L,and the 5-hydroxytryptamine was(140.25±2.61)ng/ml.In the control group,the brain-derived neurotrophic factor was(36.51±2.61)ng/ml,the norepinephrine was(8.13±1.27)μg/L,and the 5-hydroxytryptamine was(111.81±3.52)ng/ml.The levels of brain-derived neurotrophic factor,norepinephrine and 5-hydroxytryptamine in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).NIHSS score of(2.89±1.02)points in the study group was significantly lower than(4.26±1.21)points in the control group,and the difference was statistically significant(P<0.05).HAMD score of(8.24±1.02)points in the study group was significantly lower than(13.26±1.62)points in the control group,and the difference was statistically significant(P<0.05).The total effective rate of the study group was 95.00%,which was significantly higher than 80.00%of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was 7.50%,which was significantly lower than 27.50%in the control group,and the difference was statistically significant(P<0.05).Conclusion For patients with post-stroke depression of liver depression and spleen deficiency type,acupuncture moxibustion combined with fluoxetine has a better effect,which can effectively reduce the rate of complications,and is worth widely used in clinical practice.