郭晓芳 连玲霞 王艳君

摘要 目的：觀察调督通脑针法治疗脑梗死后抑郁症的临床疗效。方法：选取68例脑梗死后抑郁症患者，随机分为观察组和对照组，2组均给予西医常规治疗及普通针刺治疗，观察组加用调督通脑针法，对照组加用口服草酸西酞普兰。治疗前及治疗4周末、8周末应用汉密尔顿抑郁量表（HAMD）、临床神经功能缺损评分量表（CNFD）、日常生活活动能力量表（BI）对患者的抑郁程度、神经功能缺损程度、生活能力进行评定，同时观察不良反应。结果：治疗结束后，观察组有效率为94.12%，对照组有效率为81.82%，差异有统计学意义（P<0.05）;在改善患者HAMD评分方面，2组差异有统计学意义（P<0.05）、在临床神经功能缺损、Barthel指数评分方面，2组差异有统计学意义（P<0.05），且随着治疗时间延长，评分改善愈明显。结论：和艾司西酞普兰都能减缓患者的抑郁症状，但在促进神经功能康复及生命质量的改善方面，调督通脑针法更胜一筹。

关键词 针刺;脑梗死;并发症;抑郁症

Clinical Effects on Du-regulating and Cerebrovascular-unblocking Acupuncture Therapy

in the Treatment of Depression after Cerebral Infarction

Guo Xiaofang1， Lian Lingxia1， Wang Yanjun2

（1 Handan Hospital of Traditional Chinese Medicine， Handan 056001， China;

2 Hebei Province Hospital of TCM， Shijiazhuang 050011， China）

Abstract Objective：To observe the clinical effects of Du-regulating and cerebrovascular-unblocking acupuncture therapy on depression after cerebral infarction. Methods：A total of 68 eligible cases of patients diagnosed with depression after cerebral infarction were admitted into Handan Hospital of Traditional Medicine from October 2015 to October 2016， which were randomly divided into the observation group and the control group according to the random number table. All the patients were treated with conventional western medicine therapy and conventional acupuncture therapy. On the basis of the conventional therapies， patients in the observation group were treated with Du-regulating and cerebrovascular-unblocking acupuncture therapy， whereas patients in the control group were treated with oral administration Escitalopram oxalate Tablets. Hamilton depression scale （HAMD）， clinical neurological function deficit scale （CNFD） and Barthel Index （BI） were used to evaluate the patients′ depression degree， nervous functional defects degree and living ability before treatment， 4 weeks and 8 weeks after treatment respectively. In addition， adverse reactions were also observed. Results：The total effective rate was 94.12% in the observation group， compared with 81.82% in the control group， and the difference was statistically significant （P<0.05）; the observation group was superior to the control group in improving the HAMD （P<0.05）， CNFD and BI scores （P<0.05）， and the differences were all statistically significant. Moreover， the grades improved more significantly with treatment time extension. Conclusion：Escitalopram oxalate， together with Du-regulating and cerebrovascular-unblocking acupuncture therapy were effective for depression after cerebral infarction， and Du-regulating and cerebrovascular-unchocking acupuncture therapy was much better in promoting the recovery of neural function and enhancing the quality of life.

Key Words Acupuncture; Cerebral infarction; Complications; Depression

中图分类号：R245;R749文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.03.036

脑梗死后抑郁是脑梗死常见的并发症之一，其发生率约41.8%[1]。现代医学认为脑梗死后抑郁首选药物治疗，目前应用较多的是5-羟色胺再摄取抑制剂（SSRI），包括西酞普兰、舍曲林等。因药物不良反应导致依从性较差，而采用针刺治疗脑梗死后抑郁具有疗效确切，安全实用的特点。“调督通脑针法”以百会、神庭、哑门等头部腧穴为主穴，体现调节阴阳平衡、调督通脑的宗旨，我们对34例脑梗死后抑郁患者应用调督通脑针法取得良好效果，现报道如下。

1 资料与方法

1.1 一般资料

选取2015年10月至2016年10月邯郸市中医院脑二科住院被确诊为脑梗死并发抑郁症患者68例，均依据随机数字表法[2]分为观察组和对照组，其中对照组有1例脱落。观察组34例，男18例，女16例，年龄38～65岁，平均年龄（57.8±0.4）岁，病程4周至2年，平均病程（1.3±0.2）年。对照组33例，男17例，女16例，年龄40～65岁，平均年龄（56.5±0.3）岁，病程6周至2.2年，平均病程（1.5±0.1）年。……