针灸联合草酸艾司西酞普兰治疗脑卒中后抑郁症临床研究  

Clinical Study on Acupuncture and Moxibustion Combined with Escitalopram Oxalate for Depression After Stroke

作　　者：余娜 方盛 胡飘飘 YU Na;FANG Sheng;HU Piaopiao

机构地区：[1]金华市第二医院康复科,浙江金华321000

出　　处：《新中医》2023年第6期145-149,共5页New Chinese Medicine

摘　　要：目的:观察针灸联合草酸艾司西酞普兰治疗脑卒中后抑郁症的临床疗效。方法:将70例脑卒中后抑郁症患者按随机数字表法分为治疗组与对照组各35例。对照组给予草酸艾司西酞普兰治疗,治疗组在对照组的基础上联合针灸治疗。分别检测2组治疗前后脑损伤相关指标[中枢神经特异性生物蛋白(S100β)和髓鞘碱性蛋白(MBP)]水平,应用汉密尔顿抑郁量表(HAMD)(17项版)评定抑郁状况,简易精神状态评价量表(MMSE)检测认知功能障碍,美国国立卫生研究院卒中量表(NIHSS)评定神经功能缺损状况,功能独立性评定量表(FIM)评定患者日常生活活动能力,并记录临床疗效及不良反应发生情况。结果:治疗组总有效率为94.29%,对照组为74.29%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组S100β、MBP水平比较,差异无统计学意义(P>0.05);治疗后,2组S100β、MBP水平均较治疗前降低(P<0.05),且治疗组S100β、MBP水平均低于对照组(P<0.05)。治疗前,2组HAMD、MMSE、NIHSS、FIM评分比较,差异无统计学意义(P>0.05)。治疗后,2组HAMD、NIHSS评分均较治疗前降低(P<0.05),MMSE、FIM评分均较治疗前升高(P<0.05);且治疗组上述各项评分改善较对照组更显著(P<0.05)。治疗过程中,治疗组不良反应发生率为5.71%,对照组为14.29%,2组比较,差异无统计学意义(P>0.05)。结论:针灸联合草酸艾司西酞普兰治疗脑卒中后抑郁症疗效显著,能有效改善患者神经损伤相关指标、抑郁状态及认知功能障碍,促进其神经功能恢复,提高患者日常生活活动能力,且不良反应相对较少。Objective: To observe the clinical effect of acupuncture and moxibustion combined with Escitalopram Oxalate for post-stroke depression. Methods: A total of 70 cases of patients with poststroke depression were divided into the treatment group and the control group according to the random number table method, with 35 cases in each group. The control group was treated with Escitalopram Oxalate,and the treatment group was additionally treated with acupuncture and moxibustion based on the treatment of the control group. Before and after treatment,the relevant indexes of brain injury including S100β protein and myelin basic protein(MBP) were detected in the two groups. The Hamilton Depression Scale(HAMD-17) was applied to evaluate depression status,Mini-Mental State Examination(MMSE) to detect cognitive dysfunction, National Institute of Health Stroke Scale(NIHSS) to assess neurological deficits, and Functional Independence Measure(FIM) to evaluate activities of daily living. The curative effects and the incidence of adverse reactions were recorded. Results:The total effective rate was 94.29%in the treatment group and 74.29% in the control group,the difference being significant(P<0.05). Before treatment,there was no significant difference being found in the comparison of levels of S100β and MBP between the two groups(P>0.05). After treatment,the levels of S100β and MBP in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of S100β and MBP in the treatment group were lower than those in the control group(P<0.05). Before treatment, there was no significant difference being found in the comparison of scores of HAMD,MMSE,NIHSS and FIM between the two groups(P>0.05). After treatment, the scores of HAMD and NIHSS in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of MMSE and FIM were increased when compared with those before treatment(P<0.05);the improvement of the above scores in the treatment group was more significant than that

关 键 词：脑卒中 抑郁症 针灸疗法 草酸艾司西酞普兰 S100Β蛋白 髓鞘碱性蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]