针刺联合经颅磁刺激治疗卒中后抑郁临床研究  

Clinical Study of Acupuncture plus Transcranial Magnetic Stimulation for Post-stroke Depression

作　　者：黄宏烨[1] 肖进[1] HUANG Hong-ye;XIAO Jin(Huangshi Hospital of Traditional Chinese Medicine,Huangshi 435000,China)

机构地区：[1]黄石市中医医院

出　　处：《上海针灸杂志》2019年第11期1209-1213,共5页Shanghai Journal of Acupuncture and Moxibustion

摘　　要：目的观察针刺联合经颅磁刺激(TMS)对卒中后抑郁患者抑郁情绪的改善、神经功能的恢复及免疫功能的影响。方法102例卒中后抑郁的患者,随机分为对照组50例和观察组52例。两组均给予卒中常规治疗,对照组给予氟西汀治疗,观察组给予针刺联合TMS治疗,共治疗8周。观察两组治疗前、治疗4周后和治疗8周后汉密尔顿抑郁量表(HAMD)和美国国立卫生研究院卒中量表(NIHSS)评分变化,并在治疗前和治疗4周后检查患者免疫功能相关指标的变化。结果两组治疗后HAMD评分均较同组治疗前降低(P<0.05),观察组治疗4周后HAMD评分低于对照组(P<0.05)。两组治疗后NIHSS评分均较同组治疗前降低(P<0.05),观察组治疗后NIHSS评分低于对照组(P<0.01)。治疗4周后,两组CD4^﹢水平高于同组治疗前(P<0.05),CD8^﹢、IL-2、IL-6水平低于同组治疗前(P<0.05);观察组CD3^﹢、CD4^﹢水平高于对照组(P<0.05),CD8^﹢、IL-2、IL-6水平低于对照组(P<0.05)。结论针刺联合TMS治疗能有效改善脑卒中后抑郁患者的抑郁情绪和神经功能,并提高患者的免疫功能。Objective To observe the effect of acupuncture plus transcranial magnetic stimulation(TMS)in improving the depressive mood,recovering the neurological function and immune function in post-stroke depression patients.Method A total of 102 post-stroke depression patients were randomized into a control group of 50 cases and an observation group of 52 cases.The two groups both received conventional intervention for cerebral stroke.In addition,the control group was prescribed with Fluoxetine,and the observation group was given acupuncture plus TMS,both for 8 weeks.The two groups were observed using the Hamilton Depression Scale(HAMD)and National Institute of Health Stroke Scale(NIHSS)before treatment,and after 4-week and 8-week treatment.The immune function indexes were detected before treatment and after 4-week treatment.Result The HAMD score declined after treatment in both groups(P<0.05),and the HAMD score in the observation group was lower than that in the control group after 4-week treatment(P<0.05).The NIHSS score dropped after treatment in the two groups(P<0.05),and the NIHSS score in the observation group was lower than that in the control group(P<0.01).After 4-week treatment,the level of CD4^﹢increased compared with the baseline in the two groups(P<0.05),and the levels of CD8^﹢,interleukin(IL)-2 and IL-6 were lower compared with the baseline(P<0.05);the levels of CD3^﹢and CD4^﹢in the observation group were higher than those in the control group(P<0.05),and the levels of CD8^﹢,IL-2 and IL-6 were lower in the observation group than in the control group(P<0.05).Conclusion Acupuncture plus TMS can effectively improve the depressive mood,neurological function and immune function in patients with post-stroke depression.

关 键 词：针刺疗法 中风后遗症 抑郁症 经颅磁刺激 汉密尔顿抑郁量表 美国国立卫生研究院卒中量表 

分 类 号：R246.6[医药卫生—针灸推拿学]