| BackgroundAnxiety after having a stroke is a common long-term complications of cerebrovascular diseases. It is shown by the epidemiology research in abroad that the morbidity is about20%to40%. Anxiety after apoplexy is a lasting suffering. Medium or high degree of anxiety can affect the living quality of the patients and the recovery of body function and cognition function directly or even cause a second attack of cerebrovascular diseases.In the last decade, specialist physician have been keen to the study of the emotional disorder after apoplexy. The clinical study about depression after apoplexy is fairly mature while the clinical research of anxiety after apoplexy is relatively unsufficient, expecially in the aspect of the imperfection of the randomized trails. Researches in aborad mainly concentrates in the intervention of body function recovery as well as the comparative study of the curative effects and the adverse reactions of the west medicine.Modern medicine usually adopts anti-anxiety medicines for treatment, which have different degree of side-effects. Besides, there are other problems such as some patients can not torlerate the adverse effect of medicines and some anti-anxiety medicines are ineffective. Therefore, the hotspot of the current research is to find out an effective and safe therapeutic method without toxic or side-effect to improve the living qality of the anxious patients after hacing a stroke. Acupuncture is based on the adjustment of the function of the viscera which can regulate the mood and improve the physical symptoms realted to the mood, enabling the preceding improvement of physical syptoms. By reviewing the literature research in the last decade, it is found that the majority of the current study after apoplexy has the problems of limited observing items, unregulate randomized trials and bad repeatability.Based on the adjustment of heart and gall, acupuncture enjoys the advantages of regulate operation and good repeatability and is worthy of further research in order to promote the popularization and application.ObjetiveThis paper makes comments on the curative effects by stimulating the gallbladder meridian points and the heart meridian for the treatment of PSAD as well as the effecrs on the improvement of the living standard of the patients.MethodAll patients are from the clinics of the Dongqing Chinese medicine clinic and70of them are accorded with the inclusive criteria. They are devided into two groups randomly,35of which is the heart and gallbladder treatment group and the rest of which belong to the general acupuncture group. The acupoint selection of the heart and gallbladder treatment group:Baihui, ophryon, Neiguan point and Yanglingquan point:the point selection of moxa-moxibustion is four flowers? Needles should be imbedded in bilateral Xinyu, Danyu. The point selection of the general apuncture is Baihui, Zhisanzhen, Anming, Neiguan, Shenmen, and Sanyinjiao. If the patients have phlegm then give more apuncture in the Fenglong. If the patients is Qi-deficiency, then give more apuncture in the Tazhong and Qihai. Similarly, Blood stagnation, Geyu. Kidney deficiency, Shenyu, Yaoyangguan, taixi.The heart and gallbladder treatment group:stimulate Neiguan and Yanglingquan. The depth is about10-12mm. The tecnique is to give the apuncture with regular speed to bring about the desired sensation combined with modulating QI-Xue. Then stimulate Baihui, Zhisan and the depth is about4-5mm with the same method. The time fot the retention of the needle is about30mins. Then stimulate the Sihua directly using moxa cones. Remove the unburned moxa cones with cutton swab when2/3of the moxa cones was burnt and patients feel warm or silght burning pain.5cones for each point. Finally, withdraw the imbedding needles in the bilateral Xinyu and Danyu. The intracutaneous5mm-long needle should be stimulated in and the needle handle should be left utside from the diection of outboard to the spinal column through horizontal inserction of needle. Then use the medical proof fabric to fix them. After2-day needle rentention, withdraw themubcutaneous ubcutaneous intracutaneousThe general acupuncture group:Stimulate anming, Neiguan, Shenmen, Taichong and Sanyinjiao, the depth is about10-12mm, the tecnique is to give the apuncture with regular speed to bring about the desired sensation.Then stimulate Baihui, Zhisan and the depth is about4-5mm with the same method. The time fot the retention of the needle is about30mins.Both groups receive one treatment in2days and4weeks is one treatment course. The two groups has the same basic treastment and both groups adopts regular therapy of cerebrovascular diseases. The basic apuncture therapy is applied to improve the limb function.Use HAMA and Zung SAS to evaluate the curative effects of anxiety after apoplexy before and after the treatment and meanwhile, use the three-factor score in the HAMA to refine the evaluation of the advantages of the heart and gallbladder treatment group. Apply the Bartherl BI to assess the body function recovery in the two groups before and after the treatment. Use the stroke scale—quality of life, SS-QOL to evaluate the living quality of patients from the following5aspects, overall condition, physiology, psycology, society and environment.Adopt SPSS18.0statistical analysis software to cope with the statistical methods like the descriptive analysis, Chi-square test and rank sum test. Compare the results with the general apuncture group to study the difference of curative effcts after apoplexy.Result1the treament group makes no statistical difference compared with drug group in the aspects such as gender, age, course of the disease, illness level (P>0.05). The baseline is consistent, comparable.2the total effective rate of treatment group is97.14%higher than88.57%of the control group, but the difference has no statistical significance (P>0.05), what prompted the curative effect of treatment group is equal to control group.3In treatment group, the HAMA decrease obviously after the treatment. By the paired t-test, this result has significant difference (P<0.05), which implys the exact efficacy of the treatment for anxiety. That also happens in the control group. In the contrast of the treatment group and control group, by independent sample t-test, there is no significant difference (P>0.05) shown in the curative effect.HAMA scores is composed by psychiatric anxiety, somatic anxiety, and sleep factor. Both treatments are effective in decreasing the scores of psychiatric anxiety, somatic anxiety and sleep factor, the differences have statistical significance (P<0.05). The treatment group has the equal efficacy in improving sleep of patients compared with the control group (P>0.05), but has superior efficacy in reducing patients’psychiatric and somatic anxiety symptoms (P<0.05); that indicates the method adopted by treatment group is better in treating mental and somatic anxiety than control group.4In the contrast of QOL score, both groups make comparative differences after the treatment (P<0.05) by improving QOL score, and the treatment group is doing better than the control group (P<0.05).Also, patients’physical, psychological, social, environmental score of two groups are all improved after the treatment, the difference has statistically significant (P<0.05), by analyzing the datas with Analysis of variance and LSD test. In the comparison between the control and treatment groups by the t-test, it shows that the treatment group makes statistical significance in all4cataloges compared with controls (P<0.05) after1course of treatment.5In the contrast of Zung’s anxiety self-evaluation scale (SAS), both groups make differentiation on SAS scores, what are decreased significantly (P<0.05). But compared the two groups after the treatment, no significant difference (P>0.05) is shown, which means the effects are equal6BI score reflects the degree of physical function recovery of the patients with stroke. Both groups make comparative differences after the treatment (P<0.05) by improving BI score, But compared the two groups after the treatment, no significant difference (P>0.05) is shown, which means the effects are equalThe study of the correlationship between the increasing of BI score and decreasing of HAMA score in the treatment group shows a significant difference (P<0.05), increasing BI score would increase the curative effect on anxiety.Conelusion1treatment group makes no big difference from control group in the efficacy, but the treatent group does have certain advantages in treating mental anxiety and somatic anxiety compared to the control group, besides, the points of treatment group are easy to find, the prescription is specific and repeatabe, what make it worth to popularize2the method of treatment group can effectively improve the quality of life in patients with post-stroke anxiety, which is superior to control group. |
PDF Full Text Request