针刺辨证治疗中风后抑郁症150例临床观察

目的:观察针刺辨证治疗中风后抑郁症的临床疗效。方法:300例中风后抑郁症患者随机分为针刺组150例(以"四神针"为主穴,配合中医证候分型取穴,每日1次)及氟西汀组150例(口服氟西汀每日20mg),两组疗程均为2个月。分别在治疗前后用汉密尔顿抑郁量表(HAMD)对两组患者进行评定,统计两组疗效,并对疗效与证型的关系进行分析。结果:治疗后,两组的HAMD评分均较治疗前明显下降(P0.05);针刺组HAMD的评分优于氟西汀组(P0.05)。针刺组总有效率为89.3%(134/150),氟西汀组总有效率为76.0%(114/150),两组比较差异有统计学意义(P0.05)。针刺组各证型的疗效也均优于氟西汀组(均P0.05)。结论:针刺辨证治疗中风后抑郁症疗效较好。

Clinical Observation on Acupuncture Treatment of 150 Cases of Post-stroke Depression According to Syndrom Differentiation

Objective To observe the clinical therapeutic effect of acupuncture in the treatment of post-stroke depression (PSD) in the light of syndrome differentiation. Methods A total of 300 PSD patients were randomized into acupuncture group and medication group,with 150 cases in each group.For patients of acupuncture group,Sishencong (EX-HN 1),Baihui (GV 20),Shenting (GV 24),etc.were punctured combined with other acupoints according to different syndromes,once daily for 2 months.For patients of medication group,fluoxetine (20 mg/d) was administered orally,continuously for 2 months.Hamilton's depression scale (HAMD) was used to evaluate changes of PSD patients' state after the treatment. Results After the treatment,the scores of HAMD in both groups decreased significantly ( P<0.05 ),and that of acupuncture group was remarkably lower than that of medication group ( P<0.05 ). Of the two 150 PSD patients in medication and acupuncture groups,35 (23.3%) and 16 (10.7%) cases were cured,82(54.7%) and 41(27.3%)had a marked improvement,17(11.3%) and 57(38.0%) had an improvement,and 16(10.7%) and 36(24.0%) were ineffective,with the total effective rates being 89.3% and 76.0% respectively.Chi-square test showed that the therapeutic effect of acupuncture was significantly superior to that of medication group ( P<0.05 ). Conclusion Acupuncture is effective in improving post-stroke depression in PSD patients.