观察针灸结合中药治疗缺血性卒中后抑郁的临床疗效及其对单胺类递质水平的影响OA
Observation of clinical efficacy of acupuncture and moxibustion plus traditional Chinese herbs for depression after ischemic stroke and its effects on monoamine neurotransmitter levels
目的:观察针灸结合中药治疗缺血性卒中后抑郁的临床疗效及其对单胺类递质水平的影响.方法:选取缺血性卒中后抑郁患者80例,根据随机数字表法分为对照组和观察组,每组40例.两组均用温阳解郁汤治疗;观察组加用针灸疗法.治疗4周后评估疗效.治疗前及治疗4周后对中医主要症状和抑郁症状进行评分;采用美国国立卫生院中风量表(NIHSS)评估患者神经功能,汉密尔顿抑郁量表17项(HAMD-17)评估抑郁症状,匹兹堡睡眠质量指数(PSQI)评估睡眠质量;同时检测血清单胺类递质5-羟色胺(5-HT)、去甲肾上腺素(NE)和多巴胺(DA)水平.比较两组治疗期间不良反应发生率.结果:观察组抑郁症状疗效及中医主要症状疗效的总有效率均高于对照组(P<0.05).治疗后两组各项中医主要症状、NIHSS、HAMD-17及PSQI评分均低于治疗前(P<0.05);观察组评分低于对照组(P<0.05).治疗4周后,两组患者血清5-HT、NE和DA水平均高于治疗前(P<0.05);观察组水平高于对照组(P<0.05).治疗期间两组不良反应发生率差异无统计学意义(P>0.05).结论:针灸结合中药治疗缺血性卒中后抑郁疗效显著,可有效减轻患者症状,改善神经功能及睡眠质量,提高单胺类递质水平,且安全性较高.
Objective:To observe the clinical efficacy of acupuncture and moxibustion plus traditional Chinese herbs in treating depression after ischemic stroke and its effects on monoamine neurotransmitter levels. Methods:A total of 80 patients with depression after ischemic stroke were divided into a control group and an observation group using the random number table method,with 40 cases in each group.The two groups were treated with Wen Yang Jie Yu Tang(decoction for warming Yang and relieving depression).The observation group was treated with additional acupuncture and moxibustion therapy.The therapeutic effect was evaluated after 4 weeks of treatment.The traditional Chinese medicine(TCM)main symptoms and depression symptoms were scored before and after 4 weeks of treatment.Neurological function was assessed using the National Institutes of Health stroke scale(NIHSS),depressive symptoms were evaluated by the 17-item Hamilton depression scale(HAMD-17),and sleep quality was assessed using the Pittsburgh sleep quality index(PSQI).Meanwhile,the serum levels of monoamine neurotransmitters,including 5-hydroxytryptamine(5-HT),noradrenaline(NE),and dopamine(DA),were measured.The incidence of adverse reactions during treatment was compared between the two groups. Results:The total effective rates in improving depression symptoms and TCM main symptoms in the observation group were both higher than those in the control group(P<0.05).After treatment,the scores of each TCM main symptom,NIHSS,HAMD-17,and PSQI in both groups were all lower than those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After 4 weeks of treatment,the serum levels of 5-HT,NE,and DA in both groups were all higher than those before treatment(P<0.05),and the serum levels in the observation group were higher than those in the control group(P<0.05).During the treatment period,there was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion:The treatment of acupuncture and moxibustion plus traditional Chinese herbs has significant efficacy in treating depression after ischemic stroke;it can effectively relieve the symptoms,improve neurological function and sleep quality,increase monoamine neurotransmitter levels,and has high safety.
王珊珊;薛秀娟;王文刚;相希;赵鑫;王亚静;陈爱霞;董文静;张馥晴
医药卫生
针灸疗法针药并用温针疗法缺血性中风中风后遗症抑郁随机对照试验
Acupuncture-moxibustion TherapyAcupuncture Medication CombinedWarming Needle TherapyIschemic StrokePoststroke SyndromeDepressionRandomized Controlled Trial
《针灸推拿医学（英文版）》 2026 (1)
31-38,8
This study was supported by the Science and Technology Research and Development Program Project of Qinhuangdao(秦皇岛市科学技术研究与发展计划项目,No.202301A067).
评论