针刺治疗脑卒中后抑郁：随机对照研究

【摘要】目的：探讨针刺治疗脑卒中后抑郁的疗效和安全性。方法：采用随机双盲对照设计，将符合DSM-IV目前重性抑郁发作诊断标准的43例脑卒中患者简单随机分入实验组（针刺+安慰剂）组和对照组（安慰针刺+氟西汀）；依次于治疗前、第1、2、4、6周末双盲法用Hamilton抑郁量表、Asberg抗抑郁药副作用量表和自编针刺不良反应清单进行疗效和安全性评价。结果：治疗第6周末，实验组和对照组有效率分别为73.9%（17/23）和80.0%（16/20），疗效差异无统计学意义（?2=0.222，P=0.637）；重复测量方差分析显示实验组的Asberg抗抑郁药副作用评分显著低于对照组（F=5.19，P=0.01）；两组针刺不良反应发生率分别为13.0%（3/23）和15.0%（3/20），差异无统计学意义（?2=0.034，P=0.853）。结论：针刺疗法治疗脑卒中后抑郁的疗效与氟西汀相当，没有明显药物治疗引起的副作用。【关键词】 针刺；氟西汀；脑卒中后抑郁；随机对照研究

Acupuncture for post-stroke depression:a randomized controlled trial

Abstract Objective To examine the efficacy and safety of acupuncture for post-stroke depression (PSD). Methods In this randomized, double-blind controlled study, 43 post-stroke patients with current major depression episode (DSM-IV) were randomly assigned to test group (acupuncture+placebo) and control group (sham-acupuncture+fluoxetine); Hamilton rating scale for depression, Asberg antidepressant side effect scale and a self-designed adverse effect checklist were used to measure the effectiveness and safety. Results At the end of the sixth week, the therapeutic response rates for test and control group were 73.9%(17/23) and 80.0%(16/20), respectively, no statistical difference was found in efficacy index (?2=0.222，P=0.637); Repeated measure variance analysis revealed that the antidepressant side effect score was significantly lower than control group (?2=0.222，P=0.637); the rates for adverse event were (3/23) and 15.0%(3/20) , the difference was not statistically significant (?2=0.034，P=0.853). Conclusion Acupuncture for PSD is as effective as fluoxetine without obvious antidepressant side effect.KEY WORDS Acupuncture; Fluoxetine; Post-stroke depression; randomized controlled study