电针联合中药治疗脑梗死后抑郁的疗效观察及对神经功能和生活质量的影响

Therapeutic observation of electroacupuncture plus Chinese medicine in treating depression after cerebral infarction and the effects on neurological function and quality of life

目的观察电针联合归脾汤合血府逐瘀汤治疗脑梗死后抑郁的临床疗效及对患者神经功能和生活质量的影响。方法纳入102例脑梗死后抑郁患者,按随机数字表法分为观察组和对照组,每组51例。对照组采用口服归脾汤合血府逐瘀汤治疗,观察组在对照组治疗基础上联合电针治疗。比较两组临床疗效,比较两组治疗前后中医证候积分、17项汉密尔顿抑郁量表(Hamilton depression scale-17,HAMD-17)评分、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分和脑卒中专用生活质量量表(stroke-specific quality of life scale,SS-QOL)评分的变化,比较两组治疗前后血清5-羟色胺(5-hydroxytryptamine,5-HT)和去甲肾上腺素(norepinephrine,NE)水平的变化。结果观察组总有效率高于对照组,差异具有统计学意义(P<0.05)。两组治疗后中医证候积分、HAMD-17评分和NIHSS评分均较治疗前降低(P<0.05),两组治疗后SS-QOL评分以及血清5-HT和NE水平均较治疗前升高(P<0.05)。观察组治疗后中医证候积分、HAMD-17评分和NIHSS评分均低于对照组(P<0.05),SS-QOL评分以及血清5-HT和NE水平均高于对照组(P<0.05)。结论电针联合归脾汤合血府逐瘀汤治疗脑梗死后抑郁可有效缓解症状,改善神经功能,提高生活质量,疗效优于单纯口服中药治疗。

Objective To observe the clinical efficacy of electroacupuncture plus combined Gui Pi decoction and Xue Fu Zhu Yu decoction in treating depression after cerebral infarction and the effects on the patient’s neurological function and quality of life.Method A total of 102 patients with depression after cerebral infarction were allocated to an observation group and a control group using the random number table method,each consisting of 51 cases.The control group was treated with oral administration of Gui Pi decoction and Xue Fu Zhu Yu decoction,and the observation group additionally received electroacupuncture treatment.The clinical efficacy was compared between the two groups.Before and after the intervention,the symptom score of traditional Chinese medicine(TCM),Hamilton depression scale-17(HAMD-17)score,National Institute of Health stroke scale(NIHSS)score,and stroke-specific quality of life scale(SS-QOL)score were also compared,as well as the serum levels of 5-hydroxytryptamine(5-HT)and norepinephrine(NE).Result The observation group had a higher total effective rate than the control group,and the difference was statistically significant(P<0.05).After the treatment,the TCM symptom,HAMD-17,and NIHSS scores decreased in both groups(P<0.05),and the SS-QOL score and serum 5-HT and NE levels increased(P<0.05).The TCM symptom,HAMD-17,and NIHSS scores were lower in the observation group than in the control group after the treatment(P<0.05),and the SS-QOL score and serum 5-HT and NE levels were higher in the observation group(P<0.05).Conclusion Electroacupuncture plus combined Gui Pi decoction and Xue Fu Zhu Yu decoction can mitigate symptoms,improve neurological function,and enhance the quality of life in treating depression after cerebral infarction,producing more significant efficacy than oral Chinese medicine alone.