针灸治疗脑卒中抑郁症患者的疗效及对患者神经功能的影响
|
摘要
目的:探讨针灸治疗脑卒中抑郁症患者的疗效及对患者神经功能的影响。方法:选取2015年6月至2016年12月天津中医药大学第一附属医院收治的脑卒中抑郁症患者134例,按照随机表法分为观察组67例与对照组67例。对照组口服米氮平片,观察组在对照组基础上结合针灸治疗。2组疗程均为8周。比较2组治疗疗效,治疗前后NIHSS评分、HAMD评分、Balthel指数评分及血浆Cor和神经肽Y水变化。结果 :观察组治疗有效率(95.52%)高于对照组(76.12%),差异有统计学意义(P<0.05);2组治疗后NIHSS评分和HAMD评分降低,差异有统计学意义(P<0.05);观察组治疗后NIHSS评分和HAMD评分低于对照组(P<0.05);2组治疗后Balthel指数评分增加,差异有统计学意义(P<0.05);观察组治疗后Balthel指数评分高于对照组(P<0.05);2组治疗后血浆Cor降低而神经肽Y水平增加,差异有统计学意义(P<0.05);观察组治疗后血浆Cor高于对照组,而神经肽Y水平低于对照组(P<0.05)。结论 :针灸治疗脑卒中抑郁症患者疗效明显,且可改善患者神经功能,具有重要研究意义。
Objective: To investigate the efficacy of acupuncture treatment on stroke patients with depression and effects on neurological function. Methods: A total of 134 stroke patients with depression from First Hospital Affiliated to Tianjin Medical University from June 2015 to December 2016 were selected. They were randomly divided into observation group( n = 67) and control group( n = 67). The control group was treated with Mirtazapine Tablets,while the observation group was treated with acupuncture combined with the control group. The two groups were treated for 8 weeks. The therapeutic effects were compared between the two groups before and after treatment. The NIHSS score,HAMD score,Balthel index score and the changes of plasma Cor and neuropeptide Y were observed before and after treatment. Results: The total efficiency of the observation group( 95. 52 %) was higher than the control group( 76. 12 %)( χ2= 10. 364,P < 0. 05); the NIHSS score and HAMD score decreased in two groups after treatment,and there were significant differences( observation group,t = 17. 890,21. 575,control group t = 10. 243 、9. 808,P <0. 05); NIHSS score and HAMD score in the observation group after treatment were lower than the control group( t = 9. 557,11.939,P < 0. 05); Balthel score of the two groups after treatment increased,and there were significant differences( observation group t = 24. 793,control group t = 12. 827,P < 0. 05); Balthel score of the observation group after treatment was higher than the control group( t = 11. 333,P < 0. 05); plasma Cor levels decreased,and neuropeptide Y creased in two groups after treatment with statistical difference( observation group t = 10. 089,23. 183,control group t = 5. 388,17. 019,P < 0. 05); the plasma Cor of observation group after treatment was higher than the control group,while neuropeptide Y was lower than the control group( t =5. 388,7. 364,P < 0. 05). Conclusion: Acupuncture in the treatment of stroke patients with depression has significant curative effects,and can improve the neurological function of patients,with important research significance.
Objective: To investigate the efficacy of acupuncture treatment on stroke patients with depression and effects on neurological function. Methods: A total of 134 stroke patients with depression from First Hospital Affiliated to Tianjin Medical University from June 2015 to December 2016 were selected. They were randomly divided into observation group( n = 67) and control group( n = 67). The control group was treated with Mirtazapine Tablets,while the observation group was treated with acupuncture combined with the control group. The two groups were treated for 8 weeks. The therapeutic effects were compared between the two groups before and after treatment. The NIHSS score,HAMD score,Balthel index score and the changes of plasma Cor and neuropeptide Y were observed before and after treatment. Results: The total efficiency of the observation group( 95. 52 %) was higher than the control group( 76. 12 %)( χ2= 10. 364,P < 0. 05); the NIHSS score and HAMD score decreased in two groups after treatment,and there were significant differences( observation group,t = 17. 890,21. 575,control group t = 10. 243 、9. 808,P <0. 05); NIHSS score and HAMD score in the observation group after treatment were lower than the control group( t = 9. 557,11.939,P < 0. 05); Balthel score of the two groups after treatment increased,and there were significant differences( observation group t = 24. 793,control group t = 12. 827,P < 0. 05); Balthel score of the observation group after treatment was higher than the control group( t = 11. 333,P < 0. 05); plasma Cor levels decreased,and neuropeptide Y creased in two groups after treatment with statistical difference( observation group t = 10. 089,23. 183,control group t = 5. 388,17. 019,P < 0. 05); the plasma Cor of observation group after treatment was higher than the control group,while neuropeptide Y was lower than the control group( t =5. 388,7. 364,P < 0. 05). Conclusion: Acupuncture in the treatment of stroke patients with depression has significant curative effects,and can improve the neurological function of patients,with important research significance.
引文
[1]Zhao Q,Guo Y,Yang D,et al.Serotonin Transporter Gene 5-HTTLPR Polymorphism as a Protective Factor Against the Progression of PostStroke Depression[J].Mol Neurobiol,2016,53(3):1699-1705.
[2]张霁.浅析头部电针透刺用于64例脑卒中抑郁症患者治疗中的临床效果[J].中国继续医学教育,2016,8(7):177-178.
[3]Zhang L,Sui RB.Proton Magnetic Resonance Spectroscopy Study on the Metabolism Changes of Cerebellum in Patients with Post-Stroke Depression[J].Cell Physiol Biochem,2017,41(4):1393-1402.
[4]陈鹏启.柴桂温胆定志汤合用氟哌噻吨美利曲辛治疗脑卒中抑郁症的研究[J].中国继续医学教育,2015,7(16):184-185.
[5]张乐翊.中风解郁汤联合氟西汀治疗脑卒中抑郁症的疗效观察[J].现代中西医结合杂志,2016,25(6):634-636.
[6]岳红霞.针灸联合体感音乐治疗对脑卒中后抑郁患者康复的影响[J].吉林中医药,2015,35(2):203-205.
[7]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[8]中华医学会精神科学会主编.中国精神疾病分类方案与诊断标准(CCMD-3)[M].3版.济南:山东科学技术出版社,2001:230.
[9]陈永新,朱利芳,李焕芬,等.米氮平联合杏灵分散片治疗脑卒中后抑郁症的疗效分析[J].世界中西医结合杂志,2015,10(1):100-102.
[10]孙成梅,刘晶晶,范爱娥.认知干预改善脑卒中后抑郁症患者神经功能和认知功能的效果分析[J].中外医疗,2016,35(25):153-155.
[11]梁友云,马纯.柴胡疏肝散加针灸配合三级康复治疗脑卒中后抑郁的疗效观察[J].四川中医,2015,33(07):115-117.
[12]胡阳,高昆.针灸配合西药治疗脑卒中后抑郁症的疗效与安全性评价[J].云南中医中药杂志,2016,37(2):54-55.
[13]沈显群,龚自力.血清高迁移率族蛋白B1白细胞介素-18和-23S100 B及同型半胱氨酸和神经肽Y水平检测对缺血性脑卒中预后的影响[J].中国实用神经疾病杂志,2015,6(19):16-18.
[14]薛忠元,宋洋.帕罗西汀对脑卒中后抑郁症患者血浆P物质、神经肽Y和促肾上腺皮质激素释放因子的影响[J].中国老年学杂志,2012,32(10):2148-2149.
[15]林优美,褚文浩,汤义平.度洛西汀对脑卒中后抑郁症患者下丘脑-垂体-肾上腺轴及认知功能的影响[J].中国乡村医药,2017,24(1):12-13.
[16]陈巧莲,钟根明.氟西汀对脑卒中后抑郁症患者下丘脑-垂体-肾上腺素轴功能的影响[J].中国药业,2012,21(2):32-33.
[2]张霁.浅析头部电针透刺用于64例脑卒中抑郁症患者治疗中的临床效果[J].中国继续医学教育,2016,8(7):177-178.
[3]Zhang L,Sui RB.Proton Magnetic Resonance Spectroscopy Study on the Metabolism Changes of Cerebellum in Patients with Post-Stroke Depression[J].Cell Physiol Biochem,2017,41(4):1393-1402.
[4]陈鹏启.柴桂温胆定志汤合用氟哌噻吨美利曲辛治疗脑卒中抑郁症的研究[J].中国继续医学教育,2015,7(16):184-185.
[5]张乐翊.中风解郁汤联合氟西汀治疗脑卒中抑郁症的疗效观察[J].现代中西医结合杂志,2016,25(6):634-636.
[6]岳红霞.针灸联合体感音乐治疗对脑卒中后抑郁患者康复的影响[J].吉林中医药,2015,35(2):203-205.
[7]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[8]中华医学会精神科学会主编.中国精神疾病分类方案与诊断标准(CCMD-3)[M].3版.济南:山东科学技术出版社,2001:230.
[9]陈永新,朱利芳,李焕芬,等.米氮平联合杏灵分散片治疗脑卒中后抑郁症的疗效分析[J].世界中西医结合杂志,2015,10(1):100-102.
[10]孙成梅,刘晶晶,范爱娥.认知干预改善脑卒中后抑郁症患者神经功能和认知功能的效果分析[J].中外医疗,2016,35(25):153-155.
[11]梁友云,马纯.柴胡疏肝散加针灸配合三级康复治疗脑卒中后抑郁的疗效观察[J].四川中医,2015,33(07):115-117.
[12]胡阳,高昆.针灸配合西药治疗脑卒中后抑郁症的疗效与安全性评价[J].云南中医中药杂志,2016,37(2):54-55.
[13]沈显群,龚自力.血清高迁移率族蛋白B1白细胞介素-18和-23S100 B及同型半胱氨酸和神经肽Y水平检测对缺血性脑卒中预后的影响[J].中国实用神经疾病杂志,2015,6(19):16-18.
[14]薛忠元,宋洋.帕罗西汀对脑卒中后抑郁症患者血浆P物质、神经肽Y和促肾上腺皮质激素释放因子的影响[J].中国老年学杂志,2012,32(10):2148-2149.
[15]林优美,褚文浩,汤义平.度洛西汀对脑卒中后抑郁症患者下丘脑-垂体-肾上腺轴及认知功能的影响[J].中国乡村医药,2017,24(1):12-13.
[16]陈巧莲,钟根明.氟西汀对脑卒中后抑郁症患者下丘脑-垂体-肾上腺素轴功能的影响[J].中国药业,2012,21(2):32-33.