摘要
目的:观察通督调神针刺法结合认知疗法干预卒中后抑郁的临床效应,并探讨其疗效可能存在的作用机制,为临床治疗卒中后抑郁提供参考。方法:将60例卒中后抑郁患者随机分为观察组和西药组,每组30例,两组在予以脑血管疾病基础治疗的同时,采用不同方法干预,观察组采用通督调神针刺法结合认知疗法治疗,西药组予以盐酸帕罗西汀片口服,疗程均为4周,治疗前后进行汉密尔顿抑郁量表(HAMD)评定、日常生活能力评定(Barthel指数)及副反应量表(TESS)评估,观察两组临床疗效,测定患者血清5-HT水平,探讨可能的作用机制。结果:同组治疗后较治疗前比较,HAMD评分均显著降低(P<0.05),Barthel指数均提高(P<0.05),组间比较,观察组优于西药组,差异具有统计学意义(P<0.05),治疗后两组血清5-HT水平均较治疗前升高(P<0.05),两组5-HT升高幅度比较无统计学意义(P>0.05),观察组总有效率为93.3%,西药组为86.7%,两组比较差异具有统计学意义(P<0.05),观察组不良反应发生率较西药组发生率低,差异有统计学意义(P<0.05)。结论:通督调神针刺法结合认知疗法多法字干预卒中后抑郁,可以显著改善PSD患者的抑郁状态,临床应用行之有效、副反应低、操作重复性好。
Objective： To observe the clinical efficacy of Tongdu Tiaoshen needling combined with cognitive therapy treating post-stroke depression. Method： Sixty patients with post-stroke depression were randomized into observation group and control group, 30 cases in each group, using different methods to the two groups of patients based on basic treatment of cerebrovascular disease for 4 weeks. The observation group was intervened by Tongdu Tiaoshen needling combined with cognitive therapy, while the control group was by oral treatment of Paroxetine Hydrochloride Tablets. Cinical effects and side effects were evaluated with Hamilton Depression Scale （HAMD） and Assessment of daily living ability （Barthel index） and National Institute of and Treatment Emergent Side Effect Scale （TESS）, and serum levels of 5- HT were measured before and after intervention. Result： The two groups after treatment compared with before treatment,HAMD scores were significantly lower （P〈0.05）, Barthel index was increased （P〈0.05）, the observation group was significantly better than the western medicine group, with significant differences between the two groups （P〈0.05）, The serum 5-HT levels in two groups were significantly higher than those before treatment（P〈0.05）, and the increase of 5-HT levels in the two groups was not statistically significant （P〉0.05）. The total effective rate was 93.3% in the treatment group versus 86.7% in the control group, and the difference was statistically significant （P〈0.05）. The adverse reactions in observation group was lower than that in western medicine group, the difference was statistically significant （P〈0.05）. Conclusion： Tongdu Tiaoshen needling combined with cognitive therapy intervention for post-stroke depression is an effective approach to improve the depression of patients with PSD, and has good repeatability of clinical operation with low side effects. Its therapeutic mechanism may be related to increase serum 5-HT level.
出处
《世界科学技术-中医药现代化》
CSCD
2017年第8期1319-1323,共5页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
重庆市第九人民医院院级项目(编号:渝九院[2014]139号):基于"督脉通于脑"理论针刺干预不同脑区卒中后抑郁效应的临床研究
负责人:姚丽君
关键词
卒中后抑郁
针刺
认知疗法
疗效
post stroke depression, need ling, cognitive therapy
