针刺配合高压氧治疗脑卒中后抑郁症临床观察
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摘要
目的观察针刺配合高压氧治疗脑卒中后抑郁症的临床疗效。方法将120例脑卒中后抑郁症患者随机分为治疗组60例和对照组60例,治疗组予针刺配合高压氧治疗,对照组予氟西汀胶囊(百优解)治疗。治疗前及治疗14 d、28 d后分别采用汉密尔顿抑郁量表(HAMD)及神经功能缺损量表(NIHSS)对患者进行评定,比较两组的疗效。结果治疗组疗效明显优于对照组(P<0.01)。治疗1个疗程后,两组HAMD及NIHSS评分均有下降,治疗组与治疗前比较差异有统计学意义(P<0.01),但对照组与治疗前比较差异无统计学意义(P>0.05)。治疗2个疗程后,两组HAMD及NIHSS评分与治疗前比较差异均有统计学意义(P<0.01),且治疗组下降更明显(P<0.01)。结论针刺配合高压氧治疗脑卒中后抑郁症明确有效,而且能明显改善神经功能。
Objective To observe the clinical efficacy of acupuncture plus hyperbaric oxygen in treating depression after cerebral stroke. Method A total of 120 patients with depression after cerebral stroke were randomized into a treatment group of 60 cases and a control group of 60 cases. The treatment group was intervened by acupuncture plus hyperbaric oxygen, while the control group was intervened by Fluoxetine. Before the treatment, and respectively after 14-d and 28-d treatments, the patients were evaluated by Hamilton Depression Scale(HAMD) and National Institute of Health Stroke Scale(NIHSS), and the therapeutic efficacies were compared between the two groups. Result The treatment group was significantly superior to the control group in comparing therapeutic efficacy(P<0.01). After 1 course of treatment, the HAMD and NIHSS scores dropped significantly in the treatment group(P<0.01); the scores in the control group showed a declining tendency but without statistical significances(P>0.05). After 2 treatment courses, the HAMD and NIHSS scores were significantly different from those before the treatment in both groups(P<0.01), and the differences were more significant in the treatment group(P<0.01). Conclusion Acupuncture plus hyperbaric oxygen is effective in treating depression after cerebral stroke, and it can obviously improve the neural function.
Objective To observe the clinical efficacy of acupuncture plus hyperbaric oxygen in treating depression after cerebral stroke. Method A total of 120 patients with depression after cerebral stroke were randomized into a treatment group of 60 cases and a control group of 60 cases. The treatment group was intervened by acupuncture plus hyperbaric oxygen, while the control group was intervened by Fluoxetine. Before the treatment, and respectively after 14-d and 28-d treatments, the patients were evaluated by Hamilton Depression Scale(HAMD) and National Institute of Health Stroke Scale(NIHSS), and the therapeutic efficacies were compared between the two groups. Result The treatment group was significantly superior to the control group in comparing therapeutic efficacy(P<0.01). After 1 course of treatment, the HAMD and NIHSS scores dropped significantly in the treatment group(P<0.01); the scores in the control group showed a declining tendency but without statistical significances(P>0.05). After 2 treatment courses, the HAMD and NIHSS scores were significantly different from those before the treatment in both groups(P<0.01), and the differences were more significant in the treatment group(P<0.01). Conclusion Acupuncture plus hyperbaric oxygen is effective in treating depression after cerebral stroke, and it can obviously improve the neural function.
引文
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[6]王栩,张智龙.多指标分析法探讨针灸治疗脑卒中后抑郁症的最优方案[J].广州中医药大学学报,2015,32(1):167-170.
[7]许士奇,勾丽洁.脑卒中后抑郁的临床研究概况[J].临床荟萃,2007,22(11):828-830.
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[9]纪晓军,何宏,温兆霞,等.头穴针刺对大鼠急性脑出血血脑屏障影响的实验研究[J].中国急救医学,2001,21(11):624-625.
[10]尹俊雄,曾宪容,任泗昌,等.高压氧治疗卒中后抑郁随机对照试验的系统评价[J].中国循证医学杂志,2013,13(10):1224-1228.
[11]曹化,居克举,仲玲玲.高压氧治疗脑出血后抑郁症疗效观察[J].中国现代医学杂志,2013,23(26):94-96.
[12]刘永丹,于海娜,朴钟源,等.高压氧治疗对血管性认知功能障碍患者的抑郁及焦虑状态的影响[J].中国医药科学,2014,4(7):14-16,30.
[13]吴磊,许辉,程晓玲.奥拉西坦联合高压氧治疗急性期脑卒中后抑郁的临床疗效[J].实用临床医药杂志,2015,19(17):110-111.
[14]谢金萍,韦汶伽.音乐疗法联合高压氧治疗脑卒中后抑郁效果观察[J].中国临床新医学,2015,8(11):1089-1092.
[15]徐海虹,叶子.加味小柴胡汤合银杏叶片治疗脑卒中后抑郁症46例[J].实用中医内科杂志,2006,20(3):294-295.
[16]李德平.近年来针灸治疗脑卒中后抑郁症近况[J].甘肃中医,2008,21(7):58-59.
[17]周璇,尤艳利,钱小路,等.近年来针灸治疗卒中后抑郁证取穴规律探究[J].辽宁中医药大学学报,2014,16(8):125-127.
[18]梁艳,黄寅,程波,等.电针内关、神门穴对海洛因依赖者稽延性戒断症状疗效观察[J].上海针灸杂志,2011,30(12):804-806.
[19]蔡加,张统海,赖春柏,等.神门穴在治疗失眠中的应用[J].赣南医学院学报,2011,31(3):354.
[20]潘传会,邓大成.针刺内关穴对稳定型心绞痛的疗效观察[J].数理医药学杂志,2014,27(5):525-526.
[21]苏仁强,李伟华,焦杨.内关穴位埋线治疗稳定型心绞痛临床观察[J].上海针灸杂志,2014,33(1):31-33.
[2]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.
[3]骆洁,韩红霞.脑血管病患者病因分析及心理行为干预[J].护理实践与研究,2012,9(8):117-119.
[4]沈渔邨.精神病学[M].第3版,北京:人民卫生出版社,1994:431.
[5]刘桂花,程立.高压氧联合心理干预及舍曲林治疗脑卒中后抑郁状态的疗效[J].中国实用医刊,2012,39(5):13-15.
[6]王栩,张智龙.多指标分析法探讨针灸治疗脑卒中后抑郁症的最优方案[J].广州中医药大学学报,2015,32(1):167-170.
[7]许士奇,勾丽洁.脑卒中后抑郁的临床研究概况[J].临床荟萃,2007,22(11):828-830.
[8]徐林新,刘群才,王慧.脑梗死后抑郁的机制及临床意义[J].河南实用神经疾病杂志,2002,5(3):39.
[9]纪晓军,何宏,温兆霞,等.头穴针刺对大鼠急性脑出血血脑屏障影响的实验研究[J].中国急救医学,2001,21(11):624-625.
[10]尹俊雄,曾宪容,任泗昌,等.高压氧治疗卒中后抑郁随机对照试验的系统评价[J].中国循证医学杂志,2013,13(10):1224-1228.
[11]曹化,居克举,仲玲玲.高压氧治疗脑出血后抑郁症疗效观察[J].中国现代医学杂志,2013,23(26):94-96.
[12]刘永丹,于海娜,朴钟源,等.高压氧治疗对血管性认知功能障碍患者的抑郁及焦虑状态的影响[J].中国医药科学,2014,4(7):14-16,30.
[13]吴磊,许辉,程晓玲.奥拉西坦联合高压氧治疗急性期脑卒中后抑郁的临床疗效[J].实用临床医药杂志,2015,19(17):110-111.
[14]谢金萍,韦汶伽.音乐疗法联合高压氧治疗脑卒中后抑郁效果观察[J].中国临床新医学,2015,8(11):1089-1092.
[15]徐海虹,叶子.加味小柴胡汤合银杏叶片治疗脑卒中后抑郁症46例[J].实用中医内科杂志,2006,20(3):294-295.
[16]李德平.近年来针灸治疗脑卒中后抑郁症近况[J].甘肃中医,2008,21(7):58-59.
[17]周璇,尤艳利,钱小路,等.近年来针灸治疗卒中后抑郁证取穴规律探究[J].辽宁中医药大学学报,2014,16(8):125-127.
[18]梁艳,黄寅,程波,等.电针内关、神门穴对海洛因依赖者稽延性戒断症状疗效观察[J].上海针灸杂志,2011,30(12):804-806.
[19]蔡加,张统海,赖春柏,等.神门穴在治疗失眠中的应用[J].赣南医学院学报,2011,31(3):354.
[20]潘传会,邓大成.针刺内关穴对稳定型心绞痛的疗效观察[J].数理医药学杂志,2014,27(5):525-526.
[21]苏仁强,李伟华,焦杨.内关穴位埋线治疗稳定型心绞痛临床观察[J].上海针灸杂志,2014,33(1):31-33.