邓树峰+郑建宇+潘卫萍

【摘要】目的观察河车路走罐法治疗中风后抑郁症（PSD）阳虚型的临床疗效。方法选取符合标准的中风后抑郁症阳虚型患者120 例，随机分为观察组与对照组，每组60 例。对照组采用阿米替林治疗，观察组采用河车路走罐法治疗，比较两组治疗前后及随访1个月时汉密尔顿抑郁量表（HAMD）、改良爱丁堡-斯堪的纳维亚评分量表（MESSS）评分，根据评分评定病情和疗效。结果治疗后及随访1个月，两组患者HAMD评分显著低于治疗前（P<0.01），治疗后、随访1个月两组间分别比较，观察组评分优于对照组（P<0.01）。两组经过治疗后及随访1个月，MESSS评分均下降（P<0.05或0.01），但观察组在改善PSD患者的神经功能缺损程度方面优于对照组（P<0.01）。观察组治疗效果优于对照组，差异有统计学意义（P<0.01）。治疗中观察组3 例，药物组5例出现不良反应。 结论河车路走罐法对中风后抑郁症阳虚型患者的治疗效果显著，可改善患者的症状，提高生活质量，且不良反应轻，值得临床推广。

【关键词】河车路走罐；中风；抑郁症阳虚型

中图分类号：R259 文献标识码：ADOI：10.3969/j.issn.1003-1383.2017.04.005

【Abstract】ObjectiveTo observe the clinic effects of moving cupping on Hechelu（name of acupoint in traditional Chinese medicine）in the treatment of post stroke depression（PSD）of Yang deficiency.Methods120 cases conformed with PSD of Yang deficiency were chosen and randomly divided into observation group and control group，with 60 cases in each group.The control group were treated with amitriptyline，while the observation group were given moving cupping on the Hechelu.Then，HAMD and MESSS scores before treatment，after treatment and after one month of follow-up visit were compared，and condition and clinic effects according to the scores were evaluated.ResultsAfter treatment and one month of follow-up visit，HAMD scores of the two groups were significantly lower than those before treatment（P<0.01），and that of the observation group was superior to that of the control group（P<0.01）.The scores of MESSS in the two groups decreased after treatment and one month of follow-up visit（P<0.05 or 0.01），but the observation group was superior to the control group in improving the neurological impairment of patients with PSD（P<0.01）.The treatment effect of the observation group was better than that of the control group，difference was statistically significant（P<0.01）.During the treatment，adverse reactions were found in 3 cases in the observation group，and in 5 cases in the control group.ConclusionMoving cupping on the Hechelu has significant effect on TSD of Yang deficiency，it can improve the symptoms and life quality of patients with few adverse reactions.So，it is worth spreading in clinical practice.

【Key words】moving cupping on Hechelu；stroke；depression of Yang deficiency

中風后抑郁症（PSD）主要是中风以后导致的继发性抑郁症。临床表现为情绪低落、思维迟缓以及意志活动减少，同时，合并一定的胃肠道、心血管以及呼吸等临床不适症状，对丧失、失望、失败所形成的一种正常或异常的负面情绪[1]。中风后抑郁阳虚型属于一种常见的脑血管病并发症，长时间以来，学者将大量的精力投入到中风病研究上，针对中风后抑郁症缺乏充分的认识。抑郁的出现不仅对患者的肢体功能恢复与生存质量造成直接的影响，引发住院时间延长与病死率提高，还可能导致中风后治疗康复更加复杂。中风后30 d抑郁症的发病率约20%，中风后90～120 d的发病率在20%～60%范围内，中风后12个月内的发病率约为40%，而且患者的死亡率明显比非中风后抑郁症患者高[2]。目前对本病的治疗，多应用西药抗抑郁剂治疗，但由于其副作用大，不良反应较多，价格昂贵等，患者无法忍受，最终影响治疗[3]。……