隔药灸联合情志干预治疗卒中后抑郁的临床研究  

Clinical Study of Herb-partitioned Moxibustion Combined with Emotion Intervention for Post-stroke Depression

作　　者：杨本德 王恒 徐胜军 于振江 潘迪飞 郭秀凤[1] 王艳[1] YANG Ben-de;WANG Heng;XU Sheng-jun;YU Zhen-jiang;PAN Di-fei;GUO Xiu-feng;WANG Yan(Laigang Hospital Affiliated to Shandong First Medical University,Jinan 271126,China)

机构地区：[1]山东第一医科大学附属莱钢医院,济南271126

出　　处：《上海针灸杂志》2021年第8期920-925,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：山东省中医药科技发展计划项目(2019-0584)。

摘　　要：目的观察隔药灸神阙穴联合情志干预治疗卒中后抑郁的临床疗效及其对血同型半胱氨酸水平的影响。方法纳入100例卒中后抑郁患者并按随机数字表法分为观察组和对照组,每组50例。对照组予基础药物治疗及康复训练,观察组在对照组相同的基础药物治疗同时予隔药灸神阙穴联合情志干预。两组均治疗3个月。观察两组治疗前后的汉密尔顿抑郁量表(HAMD)评分、生活满意指数A(LSIA)评分、简化Fugl-Meyer运动功能(FMA)评分、血同型半胱氨酸(Hcy)水平变化及药物不良反应情况,比较两组的临床疗效。结果观察组总有效率为94.0%,高于对照组的75.5%,组间差异具有统计学意义(P<0.05)。与治疗前比较,两组治疗后HAMD评分、Hcy水平均明显下降(P<0.01);且观察组治疗后明显低于对照组(P<0.05)。与治疗前比较,两组治疗后LSIA评分、FMA评分均明显升高(P<0.01);且观察组治疗后明显高于对照组(P<0.05)。观察组的药物不良反应发生率为8.0%,对照组为18.4%,差异无统计学意义(P>0.05)。结论在基础药物治疗同时加用隔药灸神阙穴联合情志干预治疗卒中后抑郁可有效改善患者心理状态和抑郁程度,有助于卒中后功能障碍的康复,提高临床疗效。Objective To observe the clinical efficacy of herb-partitioned moxibustion at Shenque(CV8)plus emotion intervention in treating post-stroke depression and its effect on the level of blood homocysteine(Hcy).Method One hundred patients with post-stroke depression were divided into an observation group and a control group using random number table method,with 50 cases in each group.The control group was given pharmacological treatment and rehabilitation training,while the observation group was given the same pharmacological treatment together with herb-partitioned moxibustion at Shenque and emotion intervention.Treatment lasted for 3 months in both groups.The scores of Hamilton depression scale(HAMD),life satisfaction index A(LSIA)and simplified Fugl-Meyer assessment(FMA),and the level of blood Hcy were observed before and after treatment in the two groups,as well as the medication-related adverse reactions.Clinical efficacy was also compared between the two groups.Result The total effective rate was 94.0%in the observation group,higher than 75.5%in the control group,and the between-group difference was statistically significant(P<0.05).The HAMD score and Hcy level declined notably after treatment in both groups(P<0.01),and were lower in the observation group than in the control group(P<0.05).The scores of LSIA and FMA increased after treatment in the two groups(P<0.01),and were higher in the observation group than in the control group(P<0.05).The medication-related adverse reaction rate was 8.0%in the observation group,versus 18.4%in the control group,and the difference was statistically insignificant(P>0.05).Conclusion Based on conventional pharmacological treatment,herb-partitioned moxibustion at Shenque plus emotion intervention can effectively improve the mental state and depression in patients with post-stroke depression;it is beneficial to the rehabilitation of post-stroke dysfunction and can enhance the clinical efficacy.

关 键 词：灸法 间接灸 药饼灸疗法 穴 神阙 脑梗死 中风后遗症 抑郁 

分 类 号：R246.6[医药卫生—针灸推拿学]