针刺联合康复训练治疗脑卒中后抑郁临床观察

摘要

ObjectiveTo observe the effect of acupuncture plus rehabilitation training on the function recovery of patients with post-stroke depression.MethodNinety-eight patients with post-stroke depression were randomized into two groups to receive conventional management and anti-depressants. The control group was intervened by sham-acupuncture plus Fluoxetine tablets and comprehensive rehabilitation training, while the observation group was by acupuncture plus Fluoxetine tablets and comprehensive rehabilitation training. Prior to the intervention and after 8-week treatments, the depression state, motor function and activities of daily life (ADL) were evaluated by using Hamilton Depression Scale (HAMD), Fugl-Meyer Assessment (FMA) and Modified Barthel Index (MBI). The indexes and quality of life were also determined during the 3-month follow-up study.ResultBefore intervention, there were no significant differences in comparing HAMD, FMA and MBI scores (P>0.05). After 8-week treatment, the HAMD, FMA and MBI scores were significantlyimprovedin both groups (P<0.01,P<0.05). After treatment, the HAMD, FMA, and MBI scores in the observation group were significantlydifferent fromthat in the control group (P<0.01,P<0.05). The total effective rate was 90.0% in the observation group versus 79.2% in the control group, and the difference was statistically significant (P<0.05). The 3-month follow-up study showed significant differences in comparing the indexes between the two groups (P<0.05, P<0.01).ConclusionAcupuncture plus rehabilitation training benefits the improvement of depression state, motor function, cognitive function and quality of life in patients withpost-stroke depression, and is worth promotion.%目的：观察针刺联合康复训练对脑卒中后抑郁患者功能恢复的影响。方法将98例脑卒中后抑郁患者随机分为两组,每组患者均按常规处理及抗抑郁药物治疗。对照组予假针刺＋氟西汀片口服＋综合康复治疗；观察组予针刺＋氟西汀片口服＋综合康复治疗。在治疗前及治疗8星期后采用Hamilton抑郁量表(HAMD)、Fugl-Meyer量表(FMA)及改良Barthel(MBI)指数对患者的抑郁程度、运动功能及ADL能力进行评定,随访3个月,对其各项指标及生存质量进行评定。结果治疗前,两组患者HAMD、FMA及MBI评分比较差异无统计学意义(P＞0.05)。治疗8星期后,两组患者HAMD、FMA及MBI评分均较治疗前有所改善(P＜0.01,P＜0.05)。观察组治疗后HAMD评分、FMA评分及MBI评分与对照组比较差异有统计学意义(P＜0.01,P＜0.05)。观察组总有效率为90.0%,对照组总有效率79.2%,两组比较差异有统计学意义(P＜0.05)。随访3个月时,观察组各项指标与对照组比较差异有统计学意义(P＜0.05,P＜0.01)。结论针刺联合康复训练治疗有助于脑卒中后抑郁患者抑郁状态、运动功能、认知功能的改善及生活质量的提高,是一种值得推广的治疗方案。