头针联合通督治郁针法对脑卒中后抑郁(痰瘀互结证)患者抑郁症状及血清脑源性神经营养因子、神经生长因子水平的影响  

Effects of scalp acupuncture combined with Tongdu Zhiyu acupuncture on depressive symptoms and serum BDNF and NGF levels in patients of post-stroke depression with phlegm-stasis mutual aggregation syndrome

作　　者：李晓雷 王秋妍 刘洋 孙丽霞 李刚 LI Xiao-lei;WANG Qiu-yan;LIU Yang;SUN Li-xia;LI Gang(Department of Rehabilitation,Kaifeng Hospital of Traditional Chinese Medicine,Kaifeng 475000,Henan,CHINA;Department of Neurology,Xuchang Central Hospital,Xuchang 461001,Henan,CHINA)

机构地区：[1]开封市中医院康复科,河南开封475000 [2]许昌市中心医院神经内科,河南许昌461001

出　　处：《海南医学》2025年第6期794-799,共6页Hainan Medical Journal

基　　金：2019年度河南省中医药科学研究专题课题(编号:2019ZY3024)。

摘　　要：目的探讨头针联合通督治郁针法对痰瘀互结型脑卒中后抑郁(PSD)患者抑郁症状及血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)水平的影响。方法选取2022年8月至2024年1月开封市中医院收治的102例肝郁气滞型PSD患者作为研究对象,采用随机数表法分为对照组和针刺组各51例。对照组患者给予氟西汀治疗,针刺组患者在氟西汀治疗基础上给予头针联合通督治郁针法治疗,两组均治疗6周。比较两组患者治疗前后的中医证候积分、不良情绪、神经功能、生活质量及血清NGF、BDNF水平。结果治疗后,针刺组患者的情绪不宁、心情郁结、咽中梗阻积分分别为(2.24±1.18)分、(2.16±1.19)分、(2.12±1.16)分,明显低于对照组的(3.14±1.15)分、(3.02±1.22)分、(3.06±1.16)分,差异均具有统计学意义(P<0.05);治疗后,针刺组患者的汉密尔顿抑郁(HAMD)量表、汉密尔顿焦虑量表(HAMA)评分、美国国立卫生研究院的卒中量表(NIHSS)评分及改良爱丁堡-斯堪的那维亚脑卒中评分量表(MESSS)分别为(6.27±1.45)分、(6.34±1.35)分、(13.16±3.25)分、(13.16±3.21)分,明显低于对照组的(7.44±1.51)分、(8.39±1.48)分、(16.28±3.19)分、(17.18±3.27)分,差异均具有统计学意义(P<0.05);针刺组患者治疗后卒中专用生活质量量表(SS-QOL)评分为(190.58±10.36)分,明显高于对照组的(146.03±10.07)分,差异具有统计学意义(P<0.05);治疗后,针刺组患者的血清NGF、BDNF水平分别为(12.58±1.41)ng/L、(40.25±9.05)ng/mL,明显高于对照组的(9.86±1.33)ng/L、(32.14±8.3.05)ng/mL,差异均有统计学意义(P<0.05)。结论头针联合通督治郁针法治疗能减轻痰瘀互结型PSD患者的中医症状,缓解不良情绪,改善神经功能缺损和生活质量,提高血清神经营养因子水平。Objective To investigate the effects of scalp acupuncture combined with Tongdu Zhiyu acupuncture on depressive symptoms and serum levels of brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)in post-stroke depression(PSD)patients with phlegm-stasis mutual aggregation syndrome.Methods A total of 102 PSD patients with liver depression and Qi stagnation syndrome admitted to Kaifeng Hospital of Traditional Chinese Medicine from August 2022 to January 2024 were selected and randomly divided into a control group(n=51)and an acupuncture group(n=51).Patients in the control group received fluoxetine treatment,while those in the acupuncture group received scalp acupuncture combined with Tongdu Zhiyu acupuncture in addition to fluoxetine.Both groups were treated for 6 weeks.Traditional Chinese Medicine(TCM)syndrome scores,negative emotions,neurological function,quality of life,and serum levels of NGF and BDNF were compared before and after treatment.Results After treatment,the acupuncture group showed significantly lower scores for emotional restlessness,depressive mood,and throat obstruction,compared to the control group(all P<0.05):emotional restlessness,(2.24±1.18)points vs(3.14±1.15)points;depressive mood,(2.16±1.19)points vs(3.02±1.22)points;and throat obstruction,(2.12±1.16)points vs(3.06±1.16)points.The acupuncture group also demonstrated significantly lower Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),National Institutes of Health Stroke Scale(NIHSS),and Modified Edinburgh-Scandinavian Stroke Scale(MESSS)scores(all P<0.05):HAMD,(6.27±1.45)points vs(7.44±1.51)points;HAMA,(6.34±1.35)points vs(8.39±1.48)points;NIHSS,(13.16±3.25)points vs(16.28±3.19)points;and MESSS,(13.16±3.21)points vs(17.18±3.27)points(all P<0.05).The Stroke-specific Quality of Life Scale(SS-QOL)score in the acupuncture group was(190.58±10.36)points,significantly higher than(146.03±10.07)points of the control group(P<0.05).Additionally,serum NGF and BDNF levels in the acupuncture group were significantl

关 键 词：卒中 抑郁症 针灸 神经递质 中医证候 生活质量 

分 类 号：R743.3[医药卫生—神经病学与精神病学]