Nie Rong-Rong, Huang Chun-Hua
Department of TCM, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi Province, China.
Zhongguo Zhen Jiu. 2013 Jun;33(6):490-4.
To evaluate the efficacy and safety of acupuncture and moxibustion in the treatment of post-stroke depression (PSD) by regulating the liver and strengthening the root prescription.
In light of the random controlled trial principle, 123 cases were randomized into an acupuncture-moxibustion group (42 cases), a medication group (40 cases) and an acupuncture + medication group (41 cases). In the acupuncture-moxibustion group, the therapy of regulating the liver and strengthening the root was applied. Acupuncture was given at Hegu (LI 4), Taichong (LR 3), Baihui (GV 20, Yintang (GV 29), etc. The granule moxibustion was applied at Zhongwan (CV 12), Xiawan (CV 10), Guanyuan (CV 4) and Qihai (CV 6). The treatment was given once a day and stopped in weekend. In the medication group, paroxetine hydrochloride tablets were prescribed for oral administration, 20 mg each day after breakfast. In the acupuncture + medication group, the therapies were adopted as the acupuncture-moxibustion group and the medication group. In the 2nd and 4th week of treatment, HAMD was used as the primary index and Barthel index as the secondary one for the efficacy assessment in the three groups respectively. The spleen and stomach syndrome scale of TCM was used for the assessment of TCM syndrome efficacy. Treatment emergent symptom scale (TESS) was applied for the safety assessment.
In the 4th week of treatment, the markedly effective rates were 69.0% (29/42), 65.0% (26/40) and 70.7% (29/41) in the acupuncture-moxibustion group, the medication group and the acupuncture + medication group respectively. The efficacies of anti-depression were similar in comparison among groups (P > 0.05). In the 2nd week of treatment, the improvement of HAMD score was significant in the acupuncture + medication group as compared with that before treatment and in comparison with the medication group (P < 0.05, P < 0.01). As for improving Barthel index, reducing the spleen and stomach symptom score of TCM and decreasing the score of TESS, the results in the acupuncture-moxibustion group and the acupuncture + medication group were superior to those in the medication group (P < 0.05, P < 0.01).
The therapy of acupuncture and moxibustion with regulating the liver and strengthening the root achieves the definite efficacy of anti-depression and presents the quite high safety in treatment.
评价疏肝固本针刺艾灸法治疗脑卒中后抑郁（PSD）的疗效及安全性。
按照随机对照试验原则，将123例患者随机分为针刺艾灸组（42例）、药物组（40例）和针刺+药物组（41例）。针刺艾灸组采用疏肝固本疗法。针刺穴位选取合谷（LI 4）、太冲（LR 3）、百会（GV 20）、印堂（GV 29）等。麦粒灸穴位选取中脘（CV 12）、下脘（CV 10）、关元（CV 4）、气海（CV 6）。每日治疗1次，周末停治。药物组口服盐酸帕罗西汀片，早餐后每日20mg。针刺+药物组采用针刺艾灸组与药物组的治疗方法。治疗第2周和第4周时，分别以汉密尔顿抑郁量表（HAMD）为主要指标、Barthel指数为次要指标对三组疗效进行评估。采用中医脾胃证候量表评估中医证候疗效。应用治疗中出现的症状量表（TESS）进行安全性评估。
治疗第4周时，针刺艾灸组、药物组、针刺+药物组的显效率分别为69.0%（29/42）、65.0%（26/40）、70.7%（29/41）。各组抗抑郁疗效比较，差异无统计学意义（P＞0.05）。治疗第2周时，针刺+药物组HAMD评分较治疗前及药物组改善显著（P＜0.05，P＜0.01）。在改善Barthel指数、降低中医脾胃症状评分及降低TESS评分方面，针刺艾灸组和针刺+药物组的结果优于药物组（P＜0.05，P＜0.01）。
疏肝固本针刺艾灸法治疗脑卒中后抑郁疗效确切，安全性高。
