开关利窍、理气解郁针法治疗脑卒中后抑郁症的临床研究

目的：观察开关利窍、理气解郁针法治疗脑卒中后抑郁症（PSD）的疗效及其对患者生活质量的影响。方法：将90例PSD患者随机分为治疗组和对照组,每组45例。所有患者除接受神经内科常规治疗外,治疗组给予开关利窍、理气解郁针法治疗,对照组给予氟西汀口服治疗,疗程为4周。采用汉密尔顿抑郁量表（HRSD）评定患者的抑郁程度、改良爱丁堡＋斯堪的那维亚神经功能缺损评分量表（MSSS）评定患者的神经功能缺损程度、Bathel指数（BI）评定患者的日常生活能力,同时对两组患者抑郁程度、神经功能缺损程度改善的疗效进行评价。结果：治疗后,两组患者的HRSD评分、MSSS评分均显著降低（P〈0.05）,且治疗组的评分低于对照组（P〈0.05）;两组患者的BI指数均显著升高（P〈0.05）,且治疗组的BI指数高于对照组（P〈0.05）。治疗组抑郁症状改善的显效率为33.3%、有效率为86.7%,对照组显效率为18.6%、有效率为79.1%,治疗组改善抑郁的疗效优于对照组（P〈0.05）。治疗组神经功能缺损改善的显效率为37.8%、有效率为88.9%;对照组显效率为14.0%、有效率为81.4%,治疗组改善神经功能缺损的疗效优于对照组（P〈0.05）。结论：开关利窍、理气解郁针法治疗PSD具有较好的疗效,且可提高患者的日常生活质量。

Clinical Observation on Post-stroke Depression Treated by Orifice-opening,Qi-regulation and Depression-alleviation Needling Therapy

Objective： To observe the therapeutic effect of orifice-opening,qi-regulation and depression-alleviation needling therapy on post-stroke depression（PSD） and its influence on life quality of patients.Methods： Ninety patients with PSD were divided into the treatment group and the control group randomly with 45 cases in each group.Besides the conventional treatment,the treatment group was treated with orifice-opening,qi-regulation and depression-alleviation needling therapy,and the control group was treated with fluoxetine,with a course of 4 weeks.The depression was evaluated by Hamilton Depression Rating Scale for Depression（HRSD）,the neurological deficit was assessed by Modified Scandinavian Stroke Scale（MSSS）,and the activity of daily life（ADL） was estimated by Barthel index（BI）,meanwhile the improvement effect of depression and nervous function was evaluated.Results： After treatment,the HRSD score and MSSS score were significantly decreased（P＆lt;0.05） in both groups,and the scores of treatment group was lower than those of the control group（P＆lt;0.05）;the BI index was increased in both groups（P＆lt;0.05）,and the BI index of treatment group was higher than that of control group（P＆lt;0.05）.The marked effective rate and total effective rate of treatment group on depression improvement were 33.3% and 86.7% respectively,and the marked effective rate and total effective rate of control group were 18.6% and 79.1% respectively,with statistical difference between two groups（P＆lt;0.05）.The marked effective rate and total effective rate of treatment group on improvement of nervous function were 37.8% and 88.9% respectively,and the marked effective rate and total effective rate of control group were 14.0% and 81.4% respectively,with statistical difference between two groups（P＆lt;0.05）.Conclusion： The orifice-opening,qi-regulation and depression-alleviation needling therapy has good effect on patients with PSD,and can enhance the daily life quality of patients.