通督调神针刺结合中医辨证施护在老年脑卒中抑郁患者中的应用  

Application of Tongdu Tiaoshen acupuncture combined with traditional Chinese medicine syndrome differentiation nursing in elderly patients with post⁃stroke depression

作　　者：宋剑英[1] 高风丽 罗思一 Song Jianying;Gao Fengli;Luo Siyi(Department of Acupuncture and Moxibustion,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan,610000,P.R.China)

机构地区：[1]成都中医药大学附属医院针灸科,四川成都610000

出　　处：《老年医学与保健》2023年第4期705-710,共6页Geriatrics & Health Care

基　　金：四川省中医药管理局科学技术研究专项项目(2018LC017)。

摘　　要：目的研究通督调神针刺结合中医辨证施护在老年脑卒中抑郁(PSD)患者中的应用价值。方法选取2020年2月—2021年1月成都中医药大学附属医院收治的150例老年PSD患者作为研究对象,以数字表法随机分为观察组(n=75)和对照组(n=75)。对照组予通督调神针刺加常规康复护理,观察组在对照组处理的基础上采用中医辨证施护。观察并比较2组抑郁评分、睡眠质量评分、血清神经递质水平、神经功能、生活质量及不良反应情况。结果干预后,2组汉密尔顿抑郁量表(HAMD)评分、匹兹堡睡眠质量指数(PSQI)评分均比同组干预前降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。干预后,2组血清5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)水平均比同组干预前升高,且观察组高于对照组,差异均有统计学意义(P<0.05);2组血清去甲肾上腺素(NE)水平均比同组干预前降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。干预后,2组美国国立卫生研究院卒中量表(NIHSS)评分均比同组干预前降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。干预后,2组脑卒中专用生活质量量表(SS-QOL)中情绪、生活能力维度评分均比同组干预前升高,且观察组高于对照组,差异均有统计学意义(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。结论通督调神针刺结合中医辨证施护可改善PSD患者的抑郁情绪、睡眠质量及生活质量,调节血清神经递质水平,患者无明显不良反应发生,有望成为一种促进患者康复的有效综合干预方式。Objective To study the application effect of Tongdu Tiaoshen acupuncture combined with traditional Chi⁃nese medicine(TCM)syndrome differentiation nursing on elderly patients with post⁃stroke depression(PSD).Methods 150 elderly patients with PSD admitted to Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from February 2020 to January 2021 were selected as the study subjects,and randomly divided into observation group(n=75)and control group(n=75)by number table method.The control group received Tongdu Tiaoshen acupuncture plus routine rehabilitation therapy and nursing,while the observation group was treated with TCM syndrome differentiation nursing on the basis of the control group.The depression score,sleep quality score,levels of serum neurotransmitters,neurological function,quality of life and adverse reactions of the two groups were observed and compared.Results After intervention,the scores of Hamilton Depression Scale(HAMD)and Pittsburgh Sleep Quality Index(PSQI)of the two groups were lower than those of the same group before intervention,and the observation group was lower than the control group,with statistical significance(P<0.05).After intervention,the levels of serum 5⁃hydroxytryptamine(5⁃HT)and brain⁃derived neurotrophic factor(BDNF)of both groups were higher than those the same group before intervention,and the observation group was higher than the control group,with statistical significance(P<0.05);the level of norepinephrine(NE)of both groups was lower than that of the same group before intervention,and the observation group was lower than the control group,with statistical significance(P<0.05).After intervention,the score of National Institutes of Health Stroke Scale(NIHSS)of both groups was lower than that of the same group before intervention,and the observation group was lower than the control group,with statistical significance(P<0.05).After intervention,the scores of dimensions of“emotion”and“life ability”in the Stroke⁃Specific Quality of Life Scal

关 键 词：老年 脑卒中抑郁 通督调神针刺 抑郁 睡眠质量 中医辨证施护 

分 类 号：R248[医药卫生—中医临床基础]