调神解郁法针刺联合盐酸舍曲林片治疗卒中后抑郁:随机对照试验  

Tiaoshen Jieyu acupuncture combined with sertraline hydrochloride tablet for post-stoke depression: a randomized controlled trial

作　　者：倪思铭 蒋星卓 彭拥军 NI Si-ming;JIANG Xing-zhuo;PENG Yong-jun(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing210029,Jiangsu Province,China)

机构地区：[1]南京中医药大学附属医院针灸康复科,江苏南京210029

出　　处：《中国针灸》2023年第1期19-22,66,共5页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金面上项目:82174484、81973932;江苏省中医院高峰学术人才项目:k2021rc24;江苏省第六期“333高层次人才培养工程”项目;江苏省普通高校研究生科研创新计划项目:SJCX21_0765;国家中医药管理局课题项目:国中医药医政医管便函[2022]9号。

摘　　要：目的:比较调神解郁法针刺联合盐酸舍曲林片与单纯盐酸舍曲林片治疗卒中后抑郁(PSD)的临床疗效。方法:将76例PSD患者随机分为观察组(38例,脱落6例)和对照组(38例,脱落4例)。两组均予控制血压、抗炎等常规治疗,对照组予口服盐酸舍曲林片治疗,每次20mg,每日1次;观察组在对照组基础上联合调神解郁法针刺治疗,穴取百会、印堂、内关、太冲等,百会、印堂连接电针,予疏密波,频率2 Hz/100 Hz,每次30 min,每天1次,每周6次,两组均治疗8周。分别于治疗前后观察两组患者汉密尔顿抑郁量表(HAMD)、美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)和匹兹堡睡眠质量指数(PSQI)评分,并评定两组患者临床疗效及不良反应发生率。结果:治疗后,两组患者HAMD、NIHSS、PSQI评分均低于治疗前(P<0.05),BI评分高于治疗前(P<0.05);观察组患者HAMD、NIHSS、PSQI评分均低于对照组(P<0.05),BI评分高于对照组(P<0.05)。观察组总有效率为93.8%(30/32),高于对照组的70.6%(24/34,P<0.05)。观察组不良反应发生率为9.4%(3/32),低于对照组的32.4%(11/34,P<0.05)。结论:调神解郁法针刺联合盐酸舍曲林片可有效改善PSD患者抑郁情绪、神经功能、日常生活活动能力及睡眠质量,临床疗效优于单纯盐酸舍曲林片,且可减轻药物不良反应。Objective To compare the clinical efficacy between Tiaoshen Jieyu acupuncture(acupuncture for regulating mind and relieving depression) combined with sertraline hydrochloride tablet and simple sertraline hydrochloride tablet for post-stroke depression(PSD). Methods A total of 76 patients with PSD were randomized into an observation group(38 cases, 6 cases dropped off) and a control group(38 cases, 4 cases dropped off). Both groups were treated with conventional treatment i.e. controlling blood pressure and anti-inflammation. Sertraline hydrochloride tablet was given orally in the control group, 20 mg a time, once a day. On the basis of the treatment in the control group, Tiaoshen Jieyu acupuncture was applied at Baihui(GV 20), Yintang(GV 24+), Neiguan(PC 6), Taichong(LR 3), etc. in the observation group, Baihui(GV 20) and Yintang(GV 24+) were connected to electroacupuncture, with disperse-dense wave, 2 Hz/100 Hz in frequency,30 min a time, once a day, 6 times a week. Treatment of 8 weeks was required in both groups. Before and after treatment, the scores of Hamilton depression scale(HAMD), National Institutes of Health stroke scale(NIHSS), Barthel index(BI) and Pittsburgh sleep quality index(PSQI) were observed respectively, the therapeutic efficacy and rate of adverse reactions were evaluated in the two groups. Results After treatment, the scores of HAMD, NIHSS and PSQI were lower while BI scores were higher than those before treatment in both groups(P<0.05);the scores of HAMD, NIHSS and PSQI in the observation group were lower while BI score was higher than those in the control group(P<0.05). The total effective rate was 93.8%(30/32) in the observation group, which was higher than 70.6%(24/34) in the control group(P<0.05). The rate of adverse reactions was 9.4%(3/32) in the observation group, which was lower than 32.4%(11/34) in the control group(P<0.05).Conclusion Tiaoshen Jieyu acupuncture combined with sertraline hydrochloride tablet can improve the depression degree,neurological function, activity of daily

关 键 词：卒中后抑郁 针刺 调神解郁法 盐酸舍曲林片 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]