调神通窍针刺治疗卒中后抑郁临床疗效观察

Observation on Clinical Effects of Treating Post-stroke Depression with Adjusting-spirit Unblocking-orifices Acupuncture

目的:观察调神通窍针刺治疗卒中后抑郁(post-stroke depression,PSD)的临床疗效。方法:将60例PSD患者按照随机数字表方法分为常规针刺组和调神针刺组各30例。两组均予脑卒中常规诊疗方案治疗,在此基础上,常规针刺组取百会穴、印堂穴、太冲穴等腧穴行常规针刺治疗;调神针刺组取百会穴、神庭穴、前顶穴等腧穴行调神针刺治疗,两组均每日治疗1次,每周治疗6天,连续治疗4周。治疗后观察两组临床疗效及汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分、双侧大脑中动脉(middle cerebral artery,MCA)平均血流速度和脑储备能力评分的变化。结果:治疗后两组临床疗效比较,差异无统计学意义(P>0.05);治疗后两组HAMD评分和脑储备能力评分均较治疗前降低(P<0.05),双侧MCA平均血流速度较治疗前增快(P<0.05),且调神针刺组HAMD评分、脑储备能力评分低于常规针刺组(P<0.05),MCA平均血流速度大于常规针刺组。结论:调神通窍针刺可明显改善PSD患者的抑郁状态及脑血流速度,提高脑储备能力。

Objective:To observe curative effects of adjusting-spirit unblocking-orifices acupuncture in the treatment of post-stroke depression(PSD).Methods:Sixty PSD patients were allocated to conventional needling group and adjusting-spirit unblocking-orifices acupuncture group according to random number table method with 30 cases in each.Both groups accepted routine diagnosis and treatment plan of stroke,based on this,conventional needling group chose Baihui(DU20),Yintang(EX-HN3),Taichong(LR3)and others to perform conventional needling;adjusting-spirit unblocking-orifices acupuncture group selected Baihui,Shenting(DU24)and Qianding(DU21)to adjust the spirit and unblock the orifices,both groups were treated once each day,six days each week,for four weeks consecutively.To observe clinical effects,the scores of HAMD,mean flow velocity of MCA,and brain reserve capacity between both groups after the treatment.Results:The difference had no statistical meaning in clinical effects between both groups after the treatment(P>0.05);after the treatment,the scores of HAMD and brain reserve capacity were lowered in both groups(P<0.05),mean flow velocity of bilateral MCA increased faster than before treatment(P<0.05),the scores of HAMD and brain reserve capacity of adjusting-spirit unblocking-orifices acupuncture group were lower than these of conventional needling group(P<0.05),mean flow velocity of MCA was larger than that of conventional needling group.Conclusion:Adjusting-spirit unblockingorifices acupuncture could obviously improve depression,cerebral blood flow velocity and brain reserve capacity in PSD patients,