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早期针刺干预对脑卒中后抑郁的影响:一项随机对照试验

[Effect of early acupuncture intervention on post-stroke depression: a randomized controlled trial].

作者信息

Chen Aiwen, Gao Yuan, Wang Guantao, Li Jia, Shen Weidong

机构信息

Department of Acupuncture and Moxibustion, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 201203,China.

Department of Acupuncture and Moxibustion, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 201203,China; Institute of Acupuncture Anesthesia, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 201203.

出版信息

Zhongguo Zhen Jiu. 2018 Nov 12;38(11):1141-4. doi: 10.13703/j.0255-2930.2018.11.001.

Abstract

OBJECTIVE

To observe the effects of conventional drug therapy combined with acupuncture and conventional drug therapy on the morbidity of post-stroke depression and recovery of neurological function in patients with acute stroke, and provide new ideas for prevention and treatment of post-stroke depression.

METHODS

Sixty patients were randomly divided into an observation group and a control group, 30 cases in each one.Conventional drug therapy was given in the control group;on the basis of conventional drug therapy,acupuncture was applied at Baihui (GV 20), Sishencong (EX-HN1), Neiguan (PC 6), Hegu (LI 4), Taixi (KI 3), etc. The treatment was given once every day, 6 times a week for 4 weeks in the two groups. The 24 Hamilton depression rating scale (HAMD), modified Edinburgh-Scandinavian stroke scale (MESSS) scores were recored before treatment, after 1 week of treatment, and after 4 weeks of treatment in the two groups,and the morbidity of post-stroke depression was compared between the two groups.

RESULTS

After 1 week of treatment, the HAMD scale scores of the two groups were higher than those before treatment (both <0.05), and the MESSS scores were lower than those before treatment in the two groups (both <0.05). After 4 weeks of treatment, the HAMD scale scores in the observation group were lower than that before treatment (<0.05), and significantly better than that in the control group (<0.01), but there was no significant difference in the control group before and after treatment (>0.05). The MESSS scores were lower than those after 1 week of treatment in the two groups (both <0.05), and the score in the observation group was significantly lower than that in the control group (<0.01). After 4 weeks of treatment, the morbidity of post-stroke depression in the observation group was 23.3% (7/30), which was lower than 66.7% (20/30) in the control group (<0.05).

CONCLUSION

Early acupuncture intervention on stroke patients can not only promote the recovery of neurological function, but also reduce the morbidity of post-stroke depression effectively.

摘要

目的

观察常规药物治疗联合针刺与单纯常规药物治疗对急性脑卒中患者卒中后抑郁发病率及神经功能恢复的影响,为卒中后抑郁的防治提供新思路。

方法

将60例患者随机分为观察组和对照组,每组30例。对照组给予常规药物治疗;观察组在常规药物治疗基础上,针刺百会(GV 20)、四神聪(EX-HN1)、内关(PC 6)、合谷(LI 4)、太溪(KI 3)等穴位。两组均每天治疗1次,每周6次,共治疗4周。记录两组治疗前、治疗1周后、治疗4周后的24项汉密尔顿抑郁量表(HAMD)评分及改良爱丁堡-斯堪的纳维亚卒中量表(MESSS)评分,并比较两组卒中后抑郁的发病率。

结果

治疗1周后,两组HAMD量表评分均高于治疗前(均P<0.05),两组MESSS评分均低于治疗前(均P<0.05)。治疗4周后,观察组HAMD量表评分低于治疗前(P<0.05),且显著低于对照组(P<0.01),而对照组治疗前后差异无统计学意义(P>0.05)。两组MESSS评分均低于治疗1周后(均P<0.05),且观察组评分显著低于对照组(P<0.01)。治疗4周后,观察组卒中后抑郁发病率为23.3%(7/30),低于对照组的66.7%(20/30)(P<0.05)。

结论

对脑卒中患者早期进行针刺干预,不仅能促进神经功能恢复,还能有效降低卒中后抑郁的发病率。

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