通督调神针法治疗缺血性脑卒中后抑郁症
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摘要
目的:探讨通督调神针法治疗缺血性脑卒中后抑郁症的临床疗效。方法:将110例缺血性脑卒中后抑郁症患者按随机数字表法分为观察组和对照组,每组55例。所有患者依据《中国脑卒中康复治疗指南》进行常规干预。对照组口服氟哌噻吨美利曲辛,每天早晨服用1片。观察组在对照组基础上予通督调神针法,每天1次,每周6次。两组连续治疗6周。比较两组汉密尔顿抑郁量表(Hamilton depression scale,HAMD)因子评分、HAMD评分、巴塞尔指数(barthel index,BI)评分及临床疗效。简明健康调查量表(the MOS item short from health survey,SF-36)评价两组生存质量。结果:治疗后,观察组HAMD各因子和HAMD评分明显低于对照组(P <0. 01),BI评分明显高于对照组(P <0. 01),治疗组治疗后SF-36各项评分明显高于对照组(P <0. 01)。观察组有效率为92. 73%,明显高于对照组的76. 36%(P <0. 05)。结论:通督调神针法治疗缺血性脑卒中后抑郁疗效显著,且可明显改善患者的生存质量。
Objective: To observe the clinical efficacy of Tongdu Tiaoshen acupuncture therapy in treating post-stroke depression.Methods: 110 patients with depression after ischemic stroke were divided into observation group and control group according to digital table method,55 cases in each group. All patients received routine intervention according to the Chinese Guidelines for Rehabilitation Treatment of Stroke. The control group was given halopethiazide and melitracen orally,taking one pill every morning. On the basis of the control group,the observation group was given Tongdu Tiaoshen acupuncture therapy once a day,six times a week.The two groups were treated continuously for 6 weeks. Hamilton Depression Scale( HAMD) factor score,HAMD scale score,Barthel Index( BI) score and clinical efficacy were compared between the two groups. The MOS item short from health survey( SF-36) was used to evaluate the quality of life of the two groups. Results: After treatment,the HAMD scale factors and HAMD scores in the observation group were significantly lower than those in the control group( P < 0. 01). BI scores were significantly higher than those in the control group( P < 0. 01),and the SF-36 scale scores in the treatment group were significantly higher than those in the control group( P < 0. 01). The effective rate of the observation group was 92. 73%,which was significantly higher than76. 36% of the control group( P < 0. 05). Conclusion: The effect of Jietongdu Tiaoshen acupuncture therapy on post-stroke depression is remarkable,and it can improve the quality of life of patients.
Objective: To observe the clinical efficacy of Tongdu Tiaoshen acupuncture therapy in treating post-stroke depression.Methods: 110 patients with depression after ischemic stroke were divided into observation group and control group according to digital table method,55 cases in each group. All patients received routine intervention according to the Chinese Guidelines for Rehabilitation Treatment of Stroke. The control group was given halopethiazide and melitracen orally,taking one pill every morning. On the basis of the control group,the observation group was given Tongdu Tiaoshen acupuncture therapy once a day,six times a week.The two groups were treated continuously for 6 weeks. Hamilton Depression Scale( HAMD) factor score,HAMD scale score,Barthel Index( BI) score and clinical efficacy were compared between the two groups. The MOS item short from health survey( SF-36) was used to evaluate the quality of life of the two groups. Results: After treatment,the HAMD scale factors and HAMD scores in the observation group were significantly lower than those in the control group( P < 0. 01). BI scores were significantly higher than those in the control group( P < 0. 01),and the SF-36 scale scores in the treatment group were significantly higher than those in the control group( P < 0. 01). The effective rate of the observation group was 92. 73%,which was significantly higher than76. 36% of the control group( P < 0. 05). Conclusion: The effect of Jietongdu Tiaoshen acupuncture therapy on post-stroke depression is remarkable,and it can improve the quality of life of patients.
引文
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[14]黄文雄,余秀梅,植奇明.通督调神针法治疗脑卒中后抑郁疗效观察[J].针灸临床杂志,2017,33(4):13-16.
[15]李霞,孟智宏,张春红.针刺治疗卒中后抑郁的机理研究概述[J].针灸临床杂志,2016,32(1):87-89.
[16]徐秀娟,倪进东,王效军.基于二阶验证性因子分析的SF-36量表结构效度的分析[J].中国卫生统计,2013,30(6):846-848.
[17]王非,潘微,李云芳.针刺配合耳穴电针治疗中风后抑郁疗效观察及其对生活质量的影响[J].上海针灸杂志,2016,35(9):1033-1035.
[2]王珍珍,张春红,王丽,等.脑卒中后抑郁相关因素分析[J].河南中医,2016,36(11):1925-1928.
[3]王翌.中西医结合治疗中风后抑郁临床研究[J].中医学报,2017,32(8):114-117.
[4]程素满,陈金峰,李志榕.西酞普兰合并神衰宁丸治疗脑卒中后抑郁症[J].中国实验方剂学杂志,2011,17(6):251-253.
[5]刘雅芳,孟毅,贾刘云,等.电针配合中药治疗卒中后抑郁临床研究[J].中医学报,2015,30(1):146-148.
[6]孙培养,储浩然,李佩芳,等.通督调神针法治疗脑卒中后抑郁:随机对照研究[J].中国针灸,2013,33(1):3-7.
[7]中华医学会精神病学分会.中国精神障碍分类与诊断标准第三版[J].中华精神科杂志,2001,34(3):184-188.
[8]中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南(2010)[J].中华神经科杂志,2010,43(2):146-153.
[9]中华医学会神经病学分会.中国脑卒中康复治疗指南[J].中国康复理论与实践,2012,18(4):301-318.
[10]赵燕,李雪,徐雯洁,等.抑郁症患者HAMD量表因子分与证候要素的相关性分析[J].天津中医药,2009,26(6):515-518.
[11]脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996,29(6):62-64.
[12]欧凤荣,刘扬,刘丹,等.SF-36量表在疾病生命质量谱构建中应用[J].中国公共卫生,2008,24(12):1213-1221.
[13]张明圆.精神科评定量表手册[M].2版.长沙:湖南科学技术出版社,1998:35-39.
[14]黄文雄,余秀梅,植奇明.通督调神针法治疗脑卒中后抑郁疗效观察[J].针灸临床杂志,2017,33(4):13-16.
[15]李霞,孟智宏,张春红.针刺治疗卒中后抑郁的机理研究概述[J].针灸临床杂志,2016,32(1):87-89.
[16]徐秀娟,倪进东,王效军.基于二阶验证性因子分析的SF-36量表结构效度的分析[J].中国卫生统计,2013,30(6):846-848.
[17]王非,潘微,李云芳.针刺配合耳穴电针治疗中风后抑郁疗效观察及其对生活质量的影响[J].上海针灸杂志,2016,35(9):1033-1035.