摘要
目的:观察在西药基础上配合针刺联合耳穴贴压治疗脑卒中后抑郁症的临床疗效,探讨治疗本病提高疗效的方法。方法:将60例脑卒中后抑郁患者随机分为观察组和对照组,每组30例。对照组口服盐酸帕罗西汀片,每次20 mg,每日1次,连续8周。观察组在西药组治疗的基础上,行针刺联合耳穴贴压治疗,针刺选百会、四神聪、神庭、印堂、神门、内关、太冲、合谷、足三里、三阴交和丰隆,留针30 min,隔日1次,每周3次,连续8周;耳穴取神门、皮质下、心和肝,每日按压3次,3~5 d重新贴压一次,连续8周。于治疗前、治疗后观察两组患者汉密尔顿抑郁量表(HAMD)总分和各因子评分,并进行临床疗效评定,同时以Asberg抗抑郁药不良反应量表(SERS)进行安全性评估。结果:治疗后,两组患者HAMD总分较治疗前均下降(均P<0.05),观察组HAMD评分较对照组低(P<0.05);其中观察组的焦虑/躯体化因子、睡眠障碍因子、绝望感因子评分在治疗后低于西药组(均P<0.05);观察组总有效率为86.7%(26/30),高于对照组的66.7%(20/30,P<0.05)。安全性评价方面:观察组SERS评分低于对照组(P<0.05)。结论:在西药治疗基础上结合针刺联合耳穴贴压可改善患者临床症状,对于脑卒中后抑郁症较为有效、安全。
Objective To observe the clinical effects of acupuncture combined with auricular point sticking based on the western medication for post stroke depression（PSD）. Methods Sixty patients with PSD were randomly assigned into an acupuncture plus auricular application group（a combination group） and a medication group, 30 cases in each one. 20 mg paroxetine hydrochloride was prescribed orally in the medication group, once a day for continuous 8 weeks. Based on the above treatment, 30-minute acupuncture was used in the combination group for 8 weeks at Baihui（GV 20）, Sishencong（EX-HN 1）,Shenting（GV 24）, Yintang（GV 29）, Shenmen（HT 7）, Neiguan（PC 6）, Taichong（LR 3）, Hegu（LI 4）, Zusanli（ST 36）, Sanyinjiao（SP 6） and Fenglong（ST 40）, once the other day and three times a week. Auricular point sticking therapy for 8 weeks was applied at shenmen（TF4）, pizhixia（AT4）, xin（CO15）, and gan（CO12）, with pressing 3 times a day and once 3–5 days. The total score and each factor scores of Hamilton’s depression scale（HAMD） were observed in the two groups before and after treatment, and Asberg’s antidepressant side-effect rating scale（SERS） and clinical effect were evaluated. Results After treatment, the total HAMD scores of the two groups decreased compared with those before treatment（both P〈0.05）, with better effect in the combination group（P〈0.05）. The scores of the combination group after treatment were lower than those in the medication group, including the anxiety/somatization factor, sleep disturbance factor, hopelessness factor（all P〈0.05）.The total effective rate of the combination group was 86.7%（26/30）, which was better than 66.7%（20/30） of the medication group（P〈0.05）. The SERS score of the combination group was lower than that of the medication group（P〈0.05）. Conclusion Acupuncture combined with auricular point sticking can improve the clinical symptoms and are effective and safe for PSD.
出处
《中国针灸》
CAS
CSCD
北大核心
2017年第6期581-585,共5页
Chinese Acupuncture & Moxibustion
基金
王净净全国名老中医药专家传承工作室:国中医药人教发[2016]42号
湖南省研究生科研创新项目:CX 2016B 354
中医诊断学国家重点学科开放基金:2015 ZYZD 27
关键词
脑卒中
抑郁
针刺
耳穴贴压
因子结构
随机对照试验
stroke
depression
acupuncture
auricular point sticking
factor structure
randomized controlled trial（RCT）
