穴位针药同注联合氟哌噻吨美利曲辛片治疗脑卒中后抑郁的临床疗效观察  

Clinical Effect of Acupoint Acupuncture and Drug Injection Combined with Flupentixol and Melitracen Tablets in the Treatment of Post-stroke Depression

作　　者：李文敬[1] LI Wenjing(Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市中医医院,河北秦皇岛066000

出　　处：《中西医结合心脑血管病杂志》2020年第16期2684-2687,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的观察穴位针药同注联合氟哌噻吨美利曲辛片治疗脑卒中后抑郁的临床疗效。方法选取2015年4月—2018年4月我院就诊的脑卒中后抑郁病人92例,采用随机数字表法分为观察组和对照组,各46例。在常规脑卒中综合治疗基础上,对照组给予氟哌噻吨美利曲辛片治疗,观察组在对照组基础上联合穴位针药同注治疗,两组均连续治疗8周。观察并比较两组临床疗效、汉密尔顿抑郁量表(HAMD)评分、血清5-羟色胺(5-HT)、多巴胺(DA)和脑源性神经营养因子(BDNF)变化及不良反应。结果治疗后,观察组总有效率高于对照组(93.48%与78.26%,P<0.05)。治疗后4周、8周,两组HAMD评分较治疗前均降低(P<0.01),且观察组HAMD评分低于对照组(P<0.01)。治疗后,两组血清5-HT、DA、BDNF较治疗前均升高(P<0.01),且观察组血清5-HT、DA、BDNF均高于对照组(P<0.01)。结论穴位针药同注联合氟哌噻吨美利曲辛片治疗脑卒中后抑郁疗效显著,可缓解病人抑郁症状,改善血清神经递质表达水平。Objective To observe clinical effect of acupoint acupuncture and drug injection combined with Flupentixol and Melitracen tablets in the treatment of post-stroke depression.Methods Ninety-two patients of post-stroke depression were randomly divided into the control group and the observation group,46 cases in each group.On the basis of routine comprehensive treatment of stroke,the control group was treated with Flupentixol and Melitracen tablets,and the observation group was combined with acupoint acupuncture and drug injection on the basis of the control group.Two groups were treated for 8 weeks.The clinical efficacy,Hamilton Depression Scale(HAMD),5-hydroxytryptamine(5-HT),dopamine(DA)and brain-derived neurotrophic factor(BDNF)were compared between two groups.Results After 8 weeks,the clinical efficacy of the observation group was significantly higher than that of the control group(93.48%vs 78.26%,P<0.05).After treatment,the HAMD scores in both groups were lower than those before treatment(P<0.05),and HAMD scores in the observation group were lower than those in the control group(P<0.01).After treatment,the levels of 5-HT,DA,and BDNF in both groups were higher than those before treatment,and the levels of 5-HT,DA,and BDNF in the observation group were significantly higher than those in the control group(P<0.01).Conclusion Acupoint acupuncture and drug injection combined with Flupentixol and Melitracen tablets were safe and effective for post-stroke depression,which could relieve depression symptoms and improve the levels of neurotransmitter.

关 键 词：脑卒中 抑郁 氟哌噻吨美利曲辛片 穴位针药同注 5-羟色胺 多巴胺 脑源性神经营养因子 

分 类 号：R743[医药卫生—神经病学与精神病学] R255.2[医药卫生—临床医学]