基于择时、辨证的隔药灸治疗轻度脑卒中后抑郁(PSD)的临床观察  

Clinical Observation on the Treatment of Mild Post-stroke Depression(PSD)with Drug Separated Moxibustion Based on Timing and Dialectics

作　　者：何东梅[1] 谈莉莉[1] 唐蓉[1] 马静[1] 黄琴[1] HE Dongmei;TAN Lili;TANG Rong(Deyang Municipal People's Hospital,Deyang Sichuan 618000,China)

机构地区：[1]德阳市人民医院,四川德阳618000

出　　处：《四川中医》2023年第1期206-210,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：四川省卫生与计划生育委员会2018年科研课题(No.18PJ522)。

摘　　要：目的:观察基于择时、辨证的隔药灸治疗脑卒中抑郁的临床疗效。方法:选择2018年5月~2019年12月在本院收治的脑卒中后轻度抑郁患者87例作为研究对象。随机分为对照组、传统艾灸组、观察组各29例。对照组予常规治疗;传统艾灸组在对照组基础上,采用传统艾灸治疗;观察组在对照组基础上,采用择时、辨证的隔药灸治疗,即针对痰瘀阻窍型采用自制化痰清窍药饼的隔药灸在每日巳时对脾俞、心俞、神门、合谷、足三里、丰隆进行治疗;而对肾亏肝郁型采用自制疏肝补肾药饼的隔药灸在每日对酉时肝俞、肾俞、太冲、三阴交、太溪、命门进行治疗。三组共干预8周。观察组干预前后的抑郁自评量表(SDS)、SF-36量表、脑电图α波、实验室检查(IL-6、Cor、BDNF的水平)。结果:在抑郁量表和脑电图α波方面,干预后观察组、传统艾灸组以及对照组的抑郁评分和脑电图α波均优于干预前,差异有统计学意义(P<0.05);组间比较观察组抑郁评分和脑电图α波均优于其余两组,差异有统计学意义(P<0.05)。在SF-36量表方面,干预后三组的各项评分均高于干预前,差异有统计学意义(P<0.05);组间比较,观察组在精力、精神健康、总体健康高于其余两组;在体力、情感职能仅高于对照组,与传统艾灸组无差异;在疼痛与社会职能,三组间差异无统计学意义(P>0.05)。在实验室检查方面,干预后除对照组的IL-6指标与干预前无差异外,其余各组各指标均优于干预前,差异有统计学意义(P<0.05);组间比较,观察组在IL-6、Cor、BDNF均优于其余两组,差异有统计学意义(P<0.05)。结论:基于择时、辨证的隔药灸,对脑卒中后抑郁患者,能有效缓解其负性情绪,提高生存质量,改善相关炎症因子以及神经因子水平,值得推广与研究。Objective:To observe the clinical efficacy of applying drug separated moxibustion based on timing and dialectics in the treatment of stroke depression.Methods:87 patients with mild depression after stroke admitted to our hospital from May 2,018 to December 2,019 were selected as the research objects.They were randomly divided into a controlled group,a traditional moxibustion group and an observation group with 29 cases in each group.The controlled group was given conventional treatment.The traditional moxibustion group was treated with traditional moxibustion on the basis of the controlled group.On the basis of the controlled group,the observation group was treated with time selective and dialectical medicine separated moxibustion,that is,according to the type of phlegm and blood stasis obstructing orifices,the self-made medicine separated moxibustion of Huatan Qingqiao Cake was used to treat Pishu,Xinshu,Shenmen,Hegu,Zusanli and Fenglong at the end of the day.For the type of kidney deficiency and liver depression,herbal separated moxibustion with self-made Shugan Bushen Cake was used to treat Youshi Ganshu,Shenshu,Taichong,Sanyinjiao,Taixi and Mingmen daily.The three groups were intervened for 8 weeks.The self rating Depression Scale(SDS),SF-36 scale and electroencephalogram of the observation group before and after the intervention were comparedαwave,laboratory examination(IL-6,Cor,BDNF levels).Results:In the depression scale and EEGα,the depression score and EEG of the observation group,the traditional moxibustion group and the controlled group after the intervention were compared,the difference was statistically significant(P<0.05).The depression score and EEG of the observation group were compared between the two groups.The difference was statistically significant(P<0.05).In SF-36 scale,the scores of the three groups after intervention were higher than those before intervention,and the difference was statistically significant(P<0.05).The observation group was higher than the other two groups in energy,ment

关 键 词：择时 辨证 隔药灸 脑卒中 抑郁 

分 类 号：R246.6[医药卫生—针灸推拿学]