通督调神针法对PSD患者COR的影响及临床研究(1)
摘 要：目的 通过通督调神针法对脑卒中后抑郁患者进行针刺治疗，观察血浆皮质醇水平的变化及临床疗效。方法 选取2015 年12 月～2016年11 月我院60例PSD患者，按数字随机法分为治疗组和对照组，每组30例。治疗组行通督调神针刺治疗，对照组行盐酸氟西汀胶囊药物治疗，治疗4周后，采用临床神经功能缺损程度评分表评定神经功能，汉密尔顿抑郁量表24项评定抑郁状态， BartheI指数评定日常活动能力，以及应用放射免疫法测定COR的含量浓度，观察两组对PSD患者治疗的疗效。结果 治疗组总有效率93.10%，对照组总有效率90.00%，两组对比差异无统计学意义(P>0.05)；两组在NIHSS、HAMD、ADL量表的改善方面，治疗组评分改善情况优于对照组，差异有统计学意义(P<0.05)；两组COR含量比较方面，两组差异无统计学意义(P>0.05)。结论 通督调神针法治疗PSD可显著改善患者的临床症状和生活质量，值得临床上进一步深入研究。
关键词：通督调神针法；脑卒中后抑郁；血浆皮质醇
, 百拇医药
中图分类号：R259 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.15.044
文章编号：1006-1959(2018)15-0137-04
Effect of Tongdutiaoshen acupuncture on COR in PSD Patients and Its Clinical Research
YAN Xiao-fei，ZHANG Yong-gen，ZHANG Wen-dong
(Department of Encephalopathy，Subject Five，the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine，Hefei 230031，Anhui，China)
, 百拇医药
Abstract：Objective To observe the change of plasma cortisol level and its clinical effect in patients with post stroke depression by acupuncture therapy of Tongdutiaoshen acupuncture.Methods 60 patients with PSD from December 2015 to November 2016 were randomly divided into treatment group and control group with 30 cases in each group.The treatment group was treated with the acupuncture treatment，and the control group was treated with Fluoxetine Hydrochloride capsules.After 4 weeks of treatment，the neurological function was evaluated by clinical neurological deficit scale.24 items of Hamilton Depression scale were used to assess depression state，BartheI index to evaluate daily activity ability，and radioimmunoassay were used to determine the concentration of COR.The therapeutic effect of the two groups on PSD patients was observed.Results The total effective rate of the treatment group was 93.10% and the total effective rate of the control group was 90.00%，the difference between the two groups was not statistically significant(P>0.05).The improvement of NIHSS， HAMD and ADL in the treatment group was better than that in the control group，the difference was statistically significant(P<0.05).There was no significant difference in COR content between the two groups(P>0.05). Conclusion The treatment of PSD with Tongdutiaoshen acupuncture can significantly improve the clinical symptoms and quality of life，which is worthy of further clinical study.
, 百拇医药
Key words：Tongdutiaoshen acupuncture；Post stroke depression；Plasma cortisol
腦卒中后抑郁症(post stroke depression，PSD)是急性脑血管病常见的并发症，是指脑卒中后出现的以抑郁为主要症状的一组情志性障碍或心理障碍，是以自我体验抑郁感受为主的临床症状群或状态[1]。脑卒中后遗留的运动障碍、言语障碍会使患者感到孤单烦恼，甚至悲观落寞，并产生自觉无用和无能的感受，属于传统医学中“郁证”的范畴。PSD患者的生存质量和生活能力的恢复同样会受到严重影响，其临床表现多样，主要有精神运动迟滞、心境低落、 兴趣下降、 睡眠障碍等。脑卒中后如遗留有抑郁，患者接受新事物的能力、注意力、记忆力等比较容易受到影响。因此，PSD也日趋成为国内外专家学者共同关注的疾病之一，通过通督调神针法对PSD患者进行针刺治疗，观察通督调神法与COR水平的相关性及临床疗效，现报道如下。, http://www.100md.com(颜小飞 张永跟 张闻东)
关键词：通督调神针法；脑卒中后抑郁；血浆皮质醇
, 百拇医药
中图分类号：R259 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.15.044
文章编号：1006-1959(2018)15-0137-04
Effect of Tongdutiaoshen acupuncture on COR in PSD Patients and Its Clinical Research
YAN Xiao-fei，ZHANG Yong-gen，ZHANG Wen-dong
(Department of Encephalopathy，Subject Five，the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine，Hefei 230031，Anhui，China)
, 百拇医药
Abstract：Objective To observe the change of plasma cortisol level and its clinical effect in patients with post stroke depression by acupuncture therapy of Tongdutiaoshen acupuncture.Methods 60 patients with PSD from December 2015 to November 2016 were randomly divided into treatment group and control group with 30 cases in each group.The treatment group was treated with the acupuncture treatment，and the control group was treated with Fluoxetine Hydrochloride capsules.After 4 weeks of treatment，the neurological function was evaluated by clinical neurological deficit scale.24 items of Hamilton Depression scale were used to assess depression state，BartheI index to evaluate daily activity ability，and radioimmunoassay were used to determine the concentration of COR.The therapeutic effect of the two groups on PSD patients was observed.Results The total effective rate of the treatment group was 93.10% and the total effective rate of the control group was 90.00%，the difference between the two groups was not statistically significant(P>0.05).The improvement of NIHSS， HAMD and ADL in the treatment group was better than that in the control group，the difference was statistically significant(P<0.05).There was no significant difference in COR content between the two groups(P>0.05). Conclusion The treatment of PSD with Tongdutiaoshen acupuncture can significantly improve the clinical symptoms and quality of life，which is worthy of further clinical study.
, 百拇医药
Key words：Tongdutiaoshen acupuncture；Post stroke depression；Plasma cortisol
腦卒中后抑郁症(post stroke depression，PSD)是急性脑血管病常见的并发症，是指脑卒中后出现的以抑郁为主要症状的一组情志性障碍或心理障碍，是以自我体验抑郁感受为主的临床症状群或状态[1]。脑卒中后遗留的运动障碍、言语障碍会使患者感到孤单烦恼，甚至悲观落寞，并产生自觉无用和无能的感受，属于传统医学中“郁证”的范畴。PSD患者的生存质量和生活能力的恢复同样会受到严重影响，其临床表现多样，主要有精神运动迟滞、心境低落、 兴趣下降、 睡眠障碍等。脑卒中后如遗留有抑郁，患者接受新事物的能力、注意力、记忆力等比较容易受到影响。因此，PSD也日趋成为国内外专家学者共同关注的疾病之一，通过通督调神针法对PSD患者进行针刺治疗，观察通督调神法与COR水平的相关性及临床疗效，现报道如下。, http://www.100md.com(颜小飞 张永跟 张闻东)