疏肝活血汤合针灸早期干预对卒中后抑郁患者预后的影响

观察疏肝活血汤配合针刺疗法早期干预对卒中后抑郁患者神经功能、抑郁症状、生活质量的影响,并与盐酸氟西汀相对照,比较2组疗效差异。将63例卒中后抑郁症患者随机分成中药针灸组31例和氟西汀组32例,在常规治疗原发病的基础上,中药针灸组给予疏肝活血汤配合针刺治疗,氟西汀组给予盐酸氟西汀口服,疗程均为4周。观察治疗前后及随访6个月时汉密尔顿抑郁量表(HAMD)、神经功能缺损评分(NIHSS)及脑卒中专用生活质量量表(SS-QOL)的评分情况。结果2组患者经治疗后HAMD及NIHSS评分均显著下降(P<0.01),而SS-QOL评分明显升高,与治疗前相比有明显差异(P<0.01),且中药针灸组优于氟西汀组(P<0.05)。研究表明疏肝活血汤配合针刺疗法早期干预能减轻PSD患者的抑郁症状和神经功能损伤症状,从而提高患者的生活质量,改善患者的预后。

Effect of early intervention of liver-smoothing and blood-activating decoction combined with acupuncture on patients with post-stroke depression

To study the effect of early intervention of liver-soothing and Blood-activating decoction combined with acupuncture in improving neurological functions, depressive symptom and life quality of patients with post-stroke depression, and compare with fluoxetine hydrochloride. Specifically, 63 patients with post-stroke depression were randomly divided into the traditional Chinese medicine(TCM) acupuncture group (31 cases) and the western medicine group (32 cases). On the basis of the conventional treatment of the primary disease, the TCM acupuncture group was treated with liver-soothing and blood-activating decoction and acupuncture, while the western medicine group was treated with fluoxetine hydrochloride for four weeks. In the follow-up visit six months later, scores of HAMD, NIHSS and SS-QOL were observed. The scores of HAMD and NIHSS of both groups were significantly decreased (P<0.01), while the scores of SS-QOL increased significantly, with a notable difference compared with that before the treatment (P<0.01). Specifically, the TCM acupuncture group's was superior to the western medicine group (P<0.05). The study suggests that the early intervention of liver-soothing and blood-activating decoction combined with acupuncture on patients with post-stroke depression has the effect in relieving depression symptom and improving neurological functions, thereby improving their quality of life and prognosis.