基于“思胜恐”理论探讨“五音调神”法对脑卒中后焦虑和恐惧心理的影响  

Effects of the“five tones to regulate the spirit”method on anxiety and fear after stroke based on the theory of“thought checks fear”

作　　者：王雪妍 刘丽 廖烜东 丁懿 冯会越 付钰 李丽[3] WANG Xueyan;LIU Li;LIAO Xuandong;DING Yi;FENG Huiyue;FU Yu;LI Li(Medical College of Rehabilitation,Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China;Jinan Vocational College of Nursing,Jinan 250102,Shandong,China;The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250000,Shandong,China)

机构地区：[1]山东中医药大学康复医学院,山东济南250014 [2]济南护理职业学院,山东济南250102 [3]山东中医药大学第二附属医院,山东济南250000

出　　处：《现代中西医结合杂志》2024年第9期1213-1218,1224,共7页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家重点研发计划项目(2018YFC1706005);国家自然科学基金资助项目(82374556);山东省中医药科技项目(Q-2022071)。

摘　　要：目的基于“思胜恐”的情志相胜理论探究“五音调神”法对脑卒中后患者焦虑和恐惧心理的影响。方法选取2021年10月—2023年3月于山东中医药大学第二附属医院康复医学科就诊的脑卒中后伴焦虑恐惧心理患者65例为研究对象,按随机数字法将其分为对照组32例和观察组33例。2组均给予脑卒中后常规治疗,在此基础上对照组给予认知行为疗法(CBT)干预,观察组给予“五音调神”法(宫调式五行音乐联合针刺印堂、神庭、百会)治疗,2组治疗周期均为4周。比较2组患者治疗前后汉密尔顿焦虑量表(HAMA)评分、恐惧视觉模拟评分(FAVS)、恐惧疾病进展简化量表(FoP-Q-SF)评分、Barthel指数及血清5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)、神经肽(NPY)水平和治疗4周后的临床疗效。结果治疗后,2组HAMA、FAVS、FoP-Q-SF评分均较治疗前明显降低(P均<0.05),Barthel指数和血清5-HT、BDNF、NGF水平均较治疗前明显升高(P均<0.05),且观察组Barthel指数以及血清5-HT、BDNF、NGF水平均明显高于对照组(P均<0.05)。观察组总有效率为96.97%(32/33),对照组为78.13%(25/32),观察组总有效率明显高于对照组(P<0.05)。结论“五音调神”法可通过调控5-HT、BDNF、NGF水平有效改善脑卒中后患者的焦虑恐惧心理,且在提高患者日常生活能力和神经功能方面效果优于CBT。Objective It is to investigate the effects of the“five tones to regulate the spirit”method on anxiety and fear after stroke based on the theory of“thought checks fear”.Methods Sixty-five post-stroke patients with anxiety and fear were selected from the Department of Rehabilitation Medicine of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine from October 2021 to March 2023,and were divided into 32 cases in the control group and 33 cases in the observation group according to the random number method.Both groups were given conventional treatment of post-stroke,additionally,the control group was treated with cognitive behavioral therapy(CBT),and the observation group was treated with“five tones to regulate the spirit”method(Gong-tonal five-element music combined with acupuncture at Yintang,Shenting,and Baihui),both groups were treated for 4 weeks.The scores of Hamilton Anxiety Scale(HAMA),Fear Analog Visual Score(FAVS),Fear of Progression Questionnaire Short Form(FoP-Q-SF),Barthel Index,and serum levels of 5-Hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDNF),and neuropeptide(NPY)of patients before and after the treatment,and the clinical efficacy after 4 weeks of treatment were compared between the two groups.Results After treatment,the scores of HAMA,FAVS and FoP-Q-SF of the two groups were significantly lower than those before treatment(all P<0.05),while the Barthel index and serum levels of 5-HT,BDNF and NGF were significantly higher than those before treatment(all P<0.05),and the Barthel index as well as serum levels of 5-HT,BDNF,and NGF of the observation group were significantly higher than those of the control group(all P<0.05).The total effective rate was 96.97%(32/33)in the observation group and 78.13%(25/32)in the control group,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion The“five tones to regulate the spirit”method can effectively improve the anxiety and fear of

关 键 词：脑卒中 “五音调神”法 焦虑 恐惧 5-羟色胺 脑源性神经营养因子 神经肽 

分 类 号：R743.3[医药卫生—神经病学与精神病学]