调神解郁法针药结合治疗脑卒中后抑郁的疗效观察及对神经营养因子、氧化应激的影响  

Curative Effect of Method of Regulating Spirit and Relieving Depression Combined with Acupuncture and TCM inTreatment of PSD and Its Effects on Neurotrophic Factors and Oxidative Stress

作　　者：朱敬滨 黄祖秀 陈凌[1] ZHU Jingbin;HUANG Zuxiu;CHEN Ling(Department of Neurology,Wenzhou Hospital of Traditional Chinese Medicine,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州市中医院神经内科,浙江温州325000

出　　处：《辽宁中医杂志》2022年第10期14-18,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：温州市科技局科研项目(Y20190726)。

摘　　要：目的 探讨“调神解郁法”针药结合治疗脑卒中后抑郁(PSD)的临床疗效及对神经营养因子、氧化应激的影响。方法 选取医院神经内科收治的PSD患者96例纳入研究,随机分为观察组与对照组各48例,两组均维持脑卒中基础治疗,对照组在基础治疗的同时给予盐酸氟西汀胶囊口服,观察组在对照组治疗的基础上加用调神解郁方口服联合调神解郁针法治疗,均连续治疗4周后进行中医证候积分及疗效评定,比较两组治疗前、后的HAMD、CD-RISC、PSQI、SS-QOL量表评分及血清BDNF、NGF、NSE、Nrf2、HO-1水平变化,观察两组患者治疗期间的不良反应发生情况。结果 观察组治疗后的有效率为93.75%(45/48),明显高于对照组的77.08%(37/48)(χ^(2)=5.352,P<0.05)。观察组治疗后的中医证候积分和HAMD、PSQI量表评分均明显低于对照组(P<0.05),CD-RISC和SS-QOL量表评分均明显高于对照组(P<0.05)。观察组治疗后的BDNF、NGF、Nrf2、HO-1水平均明显高于对照组(P<0.05),NSE水平明显低于对照组(P<0.05)。观察组治疗期间的不良反应发生率为16.67%(8/48),明显低于对照组的39.58%(19/48)(χ^(2)=6.235,P<0.05)。结论 “调神解郁法”针药结合用于PSD治疗,能够明显增强疗效,改善患者的抑郁程度,提高患者的睡眠及生活质量,并降低不良反应,该治疗作用可能与调控机体神经营养因子和抗氧化应激能力相关。Objective To investigate the clinical effect of method of “regulating spirit and relieving depression” combined with acupuncture and TCM in the treatment of post-stroke depression(PSD) and its effect on neurotrophic factors and oxidative stress.Methods Ninety-six cases of PSD patients in the Department of Neurology of the hospital were selected and randomly divided into observation group and control group, 48 cases in each group.Both groups maintained the original basic treatment of stroke.The control group was given fluoxetine hydrochloride capsule orally, while the observation group was additionally given regulating spirit and relieving depression prescriptionorally combined with regulating spirit and relieving depression acupuncture on the basis of treatment in control group.The scores of TCM symptoms and efficacy were evaluated after 4 weeks of continuous treatment.The Hamilton Depression Scale(HAMD),Connor-Davidson resilience scale(CD-RISC),Pittsburgh sleep quality index(PSQI),stroke specific quality of life scale(ss-qol) scale scores as well as the serum levels of brain derived neurotrophic factor(BDNF),nerve growth factor(NGF) and neuron specific enolase(NSE),nuclear factor E2 related factor 2(Nrf2) and heme oxygenase-1(HO-1) were compared between the two groups before and after treatment.The incidence of adverse reactions in two groups during treatment was observed.Results The effective rate of the observation group was 93.75%,which was significantly higher than that of the control group(77.08%)(χ^(2)=5.352,P<0.05).The scores of TCM syndrome, HAMD and PSQI in the observation group were significantly lower than those in the control group(P<0.05),and the scores of CD-RISC and SS-QOL in the observation group were significantly higher than those in the control group(P<0.05).After treatment, the levels of BDNF,NGF,Nrf2 and HO-1 in the observation group were significantly higher than those in the control group(P<0.05),and the level of NSE was significantly lower than that in the control group(P<0.05).The i

关 键 词：调神解郁法 脑卒中后抑郁 神经营养因子 氧化应激 疗效 

分 类 号：R255.2[医药卫生—中医内科学]