舒肝颗粒联合通督调神针法治疗中风后抑郁临床研究

Clinical Study on Shugan Granules Combined with Tongdu Tiaoshen Acupuncture for Post-stroke Depression

目的:观察舒肝颗粒联合通督调神针法治疗中风后抑郁(PSD)的临床疗效。方法:将110例PSD肝气郁结兼痰瘀阻络证患者随机分为观察组和对照组各55例。对照组口服氟哌噻吨美利曲辛片,观察组服用舒肝颗粒,并联合通督调神针法治疗。2组疗程均为8周。治疗前后评定汉密尔顿抑郁量表(HAMD-17项)因子评分、HAMD-17项评分、Barthel指数(BI)评分和简明健康调查量表(SF-36)评分,比较2组的临床疗效。结果:治疗后,观察组总有效率92.73%,高于对照组的76.36%,差异有统计学意义(P <0.05)。2组HAMD-17项各因子(焦虑、阻滞、绝望感、体质量、睡眠障碍、昼夜、认知障碍)评分、HAMD-17项评分均较治疗前降低,BI评分均较治疗前升高,差异均有统计学意义(P <0.01);观察组HAMD-17项各因子评分、HAMD-17项评分均低于对照组,BI评分高于对照组,差异均有统计学意义(P <0.01)。2组SF-36量表生理功能、躯体疼痛、生理职能、活力、情感职能、社会功能、精神健康评分均较治疗前增加(P <0.01);观察组各项评分均高于对照组(P <0.01)。结论:舒肝颗粒联合通督调神针法治疗PSD可有效改善患者的抑郁症状和日常生活活动能力,提高患者的生活质量,疗效确切。

Objective:To observe the clinical effect of Shugan granules combined with Tongdu Tiaoshen acupuncture for post stroke depression(PSD).Methods:Divided 110 cases of PSD patients with syndromes of liver-qi stagnation and phlegm stagnation obstructing collaterals randomly into the observation group and the control group,55 cases in each group.The control group was given the oral application of flupentixol and melitracen tablets,and the observation group was treated with Shugan granules combined with Tongdu Tiaoshen acupuncture.Both groups were treated for 8 weeks.Evaluated the scores of scale factors in Hamilton depression scale(HAMD-17),HAMD-17 scale,Barthel indexes(BI)and the short-form 36 health survey scale(SF-36)before and after treatment,and compared the clinical effect of the two groups.Results:After treatment,the total effective rate was 92.73%in the observation group,being higher than that of 76.36%in the control group,difference being significant(P<0.05).The scores of each HAMD-17 scale factor(anxiety,block,sense of despair,body mass,sleep disorder,day and night,cognitive disorder)and HAMD-17 scores in the two groups were decreased when compared with those before treatment;the BI scores were increased when compared with those before treatment,differences being significant(P<0.01).The scores of each factor and the HAMD-17 scores in the observation group were lower than those in the control group;the BI score was higher than that in the control group,differences being significant(P<0.01).The scores of SF-36 scale in the two groups(physiological function,physical pain,physiological function,vitality,emotional function,social function,mental health)were increased when compared with those before treatment(P<0.01);each of these scores in the observation group was higher than that in the control group(P<0.01).Conclusion:The application of Tongdu Tiaoshen acupuncture for PSD can effectively improve the depressive symptoms of patients and activity abilities of daily life and increase the quality of life of them.Its curative effect is obvious.