耳穴电针治疗2型糖尿病合并脑卒中后抑郁症的疗效观察  

Clinical Effect of Electro-acupuncture at Auricular Points in Treating Type 2 Diabetes Mellitus Complicated with Post-stroke Depression

作　　者：邵洪伟[1] SHAO Hong-Wei(Dept.of Outpatient,the Fourth Hospital Affiliated to Liaoning University of Traditional Chinese Medicine,Shenyang 110101 Liaoning,China)

机构地区：[1]辽宁中医药大学附属第四医院门诊,辽宁沈阳110101

出　　处：《广州中医药大学学报》2020年第3期457-464,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：第六批全国老中医药专家学术经验继承人项目(编号:[2017]29号)。

摘　　要：【目的】观察耳穴电针治疗2型糖尿病合并脑卒中后抑郁症(post-stroke depression,PSD)的临床疗效。【方法】将80例2型糖尿病合并PSD患者随机分为对照组和观察组,每组40例。对照组给予盐酸氟西汀胶囊口服治疗,观察组在对照组的基础上联合耳穴电针治疗。每日治疗1次,1周治疗6次,连续治疗6周。治疗6周后,比较2组患者治疗前后血清基质金属蛋白酶9(MMP-9)、血清可溶性细胞间粘附分子-1(sICAM-1)、单核细胞活性氧(ROS)水平,观察日常生活活动能力评分(MBI)、汉密尔顿抑郁量表(HAMD)评分、抗抑郁药副反应量表(SERS)评分的变化情况,并评价2组临床疗效。【结果】(1)治疗后,观察组总有效率为90.00%,对照组为75.00%。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗3周后,观察组的HAMD评分较治疗前明显改善,差异有统计学意义(P<0.05),对照组的HAMD评分改善不明显,差异无统计学意义(P>0.05);治疗6周后,2组患者的HAMD评分均较治疗前改善明显,差异有统计学意义(P<0.05),且观察组在改善HAMD评分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗3、6周后,观察组SERS评分较同期对照组降低明显,差异有统计学意义(P<0.05)。治疗6周后,观察组的SERS评分与同组治疗3周后评分比较,差异无统计学意义(P>0.05);对照组的SERS评分与同组治疗3周后评分比较,差异有统计学意义(P<0.05)。(4)治疗3、6周后,2组患者的MBI评分较治疗前均明显改善,差异有统计学意义(P<0.05),且观察组在改善MBI评分方面均明显优于对照组,差异均有统计学意义(P<0.05)。(5)治疗3周后,2组患者血清MMP-9和ROS水平均明显改善,差异有统计学意义(P<0.05);观察组血清sICAM-1水平明显改善(P<0.05),且在改善血清sICAM-1水平方面明显优于对照组(P<0.05);对照组血清sICAM-1水平稍有改善,但差异无统计学意义(P>0.05)。治疗6周后,2组患者血清MMP-9、sObjective To observe the clinical efficacy of electro-acupuncture at auricular points for the treatment of type 2 diabetes mellitus complicated with post-stroke depression(PSD). Methods Eighty patients with type 2 diabetes mellitus complicated with PSD were randomly divided into control group and observation group,40 cases in each group. The control group received fluoxetine hydrochloride orally, and the observation group received electro-acupuncture at auricular points based on the treatment of the control group. One time per day,6 times in one week, the treatment lasted 6 continuous weeks. After 6 weeks of treatment, the serum levels of matrix metalloproteinase 9(MMP-9),soluble intercellular adhesion molecule 1(sICAM-1)and reactive oxygen species(ROS), and the score of modified Barthel index(MBI)for daily living ability, Hamilton depression scale(HAMD)score and side effects rating scale(SERS)score for antidepressant adverse reaction were observed,the clinical efficacy was evaluated. Results(1)After treatment,the total effective rate was 90.00% in the observation group,and was 75.00% in the control group. The curative effect of the observation group was superior to that of the control group, the difference being statistically significant(P<0.05).(2)After 3 weeks of treatment, the improvement in HAMD score in the observation group was obvious as compared with that before treatment,the difference being statistically significant(P<0.05),and the improvement in HAMD score in the control group was not obvious as compared with that before treatment, the difference being statistically nonsignificant(P>0.05).After 6 weeks of treatment,HAMD score in the two groups was improved,and the improvement in HAMD score of the observation group was superior to that of the control group(P < 0.05).(3)After 3,6 weeks of treatment,SERS score in the observation group was lower than that in the control group at same time, the difference being statistically significant(P<0.05). After 6 weeks of treatment,there was statistically nonsignifi

关 键 词：耳穴电针 2型糖尿病 脑卒中 基质金属蛋白酶-9(MMP-9) 可溶性细胞间粘附分子(sICAM-1) 活性氧(ROS) 

分 类 号：R246.6[医药卫生—针灸推拿学]