【作者】 冯辉；

【导师】 韩景献；

【作者基本信息】 天津中医学院 ， 针灸推拿学， 2004， 硕士

【摘要】 目的：在“醒脑开窍”针刺法的基础上，探讨针刺治疗脑卒中后抑郁(PSD)的可行性，观察“开关利窍，理气解郁”针法治疗脑卒中后抑郁的疗效及对生活质量与神经功能的影响。方法：将60例确诊为PSD的住院患者随机分为针刺组和对照组各30例，除接受常规治疗和醒脑开窍针刺法外，针刺组采用“开关利窍，理气解郁”针法治疗并结合心理指导，每日针刺一次，每周休息一天，疗程为4周；对照组只采用与针刺组相同的心理指导；治疗前后分别对两组用HRSD量表评价抑郁程度，用BI指数评价日常生活质量(ADL)，用MSSS量表评价神经功能，然后将各量表分值分别进行组间与组内比较，所得数据用SPSS11． 5软件进行统计学分析。结果：1、 两组患者治疗前后HRSD量表评分有极显著性差异(P<0． 01) ，提示“开关利窍，理气解郁”针法及心理指导对于改善PSD患者的抑郁症状均有较好疗效；针刺组治疗PSD具有较高疗效(显效率43． 3％)，优于单纯心理指导的对照组(6． 7％)，两组相比有显著性差异(P<0． 05) ；2、 针刺组对患者生活质量及神经功能的测评与治疗前相比均有显著提高(P<0． 01) ，对照组与治疗前相比亦有显著提高(P<0． 01) ，但改善程度不如针刺组，两组间有显著性差异(P<0． 05) ；3、 首次发病与发病次数≥2次患者，其治疗前HRSD评分比较具有极显著性差异(P<0，01) ，针刺治疗后两者HRSD量表评分与治疗前相比均明显降低(P<0． 01) ，但治疗后两者HRSD量表评分比较差异无显著性(P>0． 05) 。结论：“开关利窍，理气解郁”针法对卒中后抑郁有肯定的治疗作用，对于提高PSD患者日常生活质量有明显的治疗意义，并且神经功能缺损程度亦随抑郁症状的改善而好转，提示此针法对卒中后抑郁有良好的调节作用。更多还原

【Abstract】 Objective: To discuss the feasibility of "Kai Guan Li Qiao, Li Qi Jie Yu" ("KGLQ, LQJY") acupuncture therapy on post-stroke depression(PSD) and observe the therapeutic effect on neurologic impairment and self-caring ability which based on "Xing Nao Kai Qiao" (XNKQ)acupuncture therapy.Methods: Sixty PSD patients were divided into the acupuncture group and the control group randomly. Besides the conventional treatment and "XNKQ" acupuncture therapy, the acupuncture group was selected with "KGLQ, LQJY " acupuncture therapy and the psychology instruction. One time per day, have a rest per week and 4 weeks for one course. The control group was only selected with the same psychology instruction. Before and in the end of treatment, we assessed ADL by Barthel index (BI), degree of neurological deficit by the Modified Scandinavian stroke scale (MSSS) and depressive symptomatology by Hamilton depression rating scale for depression (HRSD). The data was analyzed by SPSS 11.5 software. Significance was determined at p<0.05 and remarkable significance at p<0.01 by Student t-test.Results:1. The scores of HRSD of two groups have remarkable difference before and after treatment(P<0.01). And the acupuncture group has better efficacy (remarkable efficacy rate 43.3%) greatest improvement was observed in "KGLQ, LQJY" treated group (P<0.05) .2.Acupuncture group had remarkable improvement in quality of life and nerve function before and after treatment. Control group also had such effective (P<0.01). But amelioration level of acupuncture group was better than control group. There was significance between two groups (P<0.05) .3. The scores of HRSD for first time onset patients were lower than those of onset for more than two times before treatment (P<0.01). After acupuncture treatment, the level of HRDS of both of them was obviously reduced (P<0.01). But there was nosignificant difference between them after acupuncture (P>0.05 ) .Conclusions: The results suggest that "KGLQ. LQJY" acupuncture method can release depressive symptomatology of post-stroke significantly. It can improve PSD patients’ quality of daily life and neurological function.更多还原