针刺配合耳穴电针治疗中风后抑郁疗效观察及其对生活质量的影响

摘要

目的：评价针刺配合耳穴电针治疗中风后抑郁的临床疗效及其对生存质量的影响。方法将98例中风后抑郁患者随机分为治疗组和对照组，每组49例。治疗组采用针刺配合耳穴电针治疗，对照组采用口服盐酸氟西汀胶囊治疗。观察两组治疗前后汉密尔顿抑郁量表(HAMD)评分、抗抑郁药副反应量表(SERS)评分及世界卫生组织生存质量测定量表(WHOQOL-BREF)评分变化情况，并比较两组临床疗效。结果治疗组总有效率为89.1%，对照组为87.0%，两组比较差异无统计学意义(P＞0.05)。治疗组治疗2、4、8星期后HAMD评分与同组治疗前比较，差异均具有统计学意义(P＜0.05)。对照组治疗4、8星期后HAMD评分与同组治疗前比较，差异均具有统计学意义(P＜0.05)。两组治疗2、4、8星期后HAMD评分比较，差异均无统计学意义(P＞0.05)。治疗组治疗4、8星期后SERS评分与对照组比较，差异均具有统计学意义(P＜0.05)。治疗组治疗8星期后SERS评分与同组治疗4星期后比较，差异具有统计学意义(P＜0.05)。两组治疗后WHOQOL-BREF中G1、G4、生理领域、心理领域及环境领域评分与同组治疗前比较，差异均具有统计学意义(P＜0.05)。治疗组治疗后生理领域评分与对照组比较，差异具有统计学意义(P＜0.05)。结论针刺配合耳穴电针是一种治疗中风后抑郁的有效方法，能改善患者的生活质量。%Objective To evaluate the clinical efficacy of acupuncture plus auricular point electroacupuncture and its effect on the quality of life (QOL).Method Ninety-eight patients with post-stroke depression were randomized into a treatment group and a control group, 49 cases in each group. The treatment group was intervened by acupuncture plus auricular point electroacupuncture, while the control group was by oral administration of Fluoxetine hydrochloride. The Hamilton Depression Scale (HAMD), Side-effect Rating Scale (SERS), and the World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF) were observed before and after intervention, and the clinical efficacies were also compared.Result The total effective rate was 89.1% in the treatment group versus 87.0% in the control group, and the between-group difference was statistically insignificant (P>0.05). Respectively after 2-week, 4-week, and 8-week treatment, the HAMD scores were significantly different from that before intervention in the treatment group (P<0.05). Respectively after 2-week, 4-week, and 8-week treatment, the HAMD scores were significantly different from that before intervention in the control group (P<0.05). There were no significant differences in comparing the HAMD scores between the two groups after 2-week, 4-week, and 8-week treatment (P>0.05). The SERS scores in the treatment group were significantly different from that in the control group after 4-week and 8-week treatment (P<0.05). In the treatment group, the SERS score after 8-week treatment was significantly different from that after 4-week treatment (P<0.05). After treatment, the scores of general health domain 1 and 4, physical health domain, psychological health domain, and environment domain from WHOQOL-BREF were significantly changed in both groups (P<0.05). After intervention, the physical health domain score of the treatment group was significantly different from that of the control group (P<0.05).Conclusion Acupuncture plus auricular point electroacupuncture is an effective approach in treating post-stroke depression, and it can improve the quality of life of the patients.