| Objective: Post-stroke depression(PSD),usually refer to an emotional disorder disease which is generally characterized by feeling down,slower mind,losing desires and less conversation.PSD is a common consequence of stroke.PSD is associated with poor mental state and poor neurologic functional rehabilitation,which bring a negative influence for individual and the family.There are some problems exist in the common clinical anti-depressant like single effect,strong dependency and adverse reaction.For the present,traditional Chinese medicine(TCM)therapy is widely employed in PSD.This article using Governor Meridian-regulating and brain-unblocking acupuncture combined with rehabilitation training as the main intervention means,to investigate the effects on the treatment of PSD,try to establish a safe,effective and low-cost acupuncture standard scheme for the prevention and treatment of PSD,and then provide guidance for the clinical treatment.Methods: On the basis of preliminary clinical study,this article use the method of randomized controlled trials,a total of 67 PSD patients with informed consent treated in First Affiliated Hospital of Hebei Medical University,Hebei Hospital of Traditional Chinese Medicine and Xingtai Hospital of Traditional Chinese Medicine between January 2015 and January2017 were randomly divided into acupuncture group and western medicine group according to random number table.All patients were treated by routine western medicine of stroke combined with rehabilitation training.33 cases in acupuncture(2 cases fell off)were treated by Governor Meridian-regulating and brain-unblocking acupuncture.Needing in sequence of Yamen(GV 15),Xinshu(BL 15),Ganshu(BL 18),Shenshu(BL 23),Baihui(GV 20),Shenting(GV 24),Danzhong(CV 17),Neiguan(PC 6),Shenmen(HT 7),Taixi(KI 3),Taichong(LR 3).Except the Yamen and back-shu points,the other points retention of needle for 25 min,one time per day,5 times treatment per weeks for 8 weeks.34 cases(1 cases fell off)in western medicine group(1 cases fell off)were treated by oral Escitalopram Oxalate tablets.Day 1 to day 2 took1.25 mg/ d,day 3 to day 4 took 2.5 mg/ d,day 5 to day 6 took 3.75 mg/ d,5mg/d from day 7 and ultimately to 10 mg/d,continuously treatment for 8weeks.The total scores and each factor of Hamilton’s Depression Scale(HAMD)before and after 2,4,8 weeks treatment were observed in two groups,for evaluation of depression symptoms.The total scores of Barthel index(BI)and China Stroke Scale(CSS)before and after 4,8 weeks treatment were observed in two groups,for evaluation of activity of daily living and neurologic impairments.The curative effect of PSD was evaluated by HAMD reductive rate.Results:1 The cure and markedly effective rate after 8 weeks treatment in acupuncture group(81%)was superior to that in western group(51%),with statistical differences(P<0.05).2 The total scores of HAMD after 2,4 and 8 weeks treatment in acupuncture group were lower than before treatment(P < 0.05).The total score of HAMD after 2 weeks treatment in western medicine group was lower than that in before treatment,but with no statistical differences(P>0.05).The total scores of HAMD after 4,8 weeks treatment in western medicine group were lower than before treatment(P<0.05).The total scores of HAMD after2,8 weeks treatment in acupuncture group were lower than western medicine group at the same period,with statistical differences(P<0.01).3 As intra-comparison of each factor of HAMD,all 5 factors scores after2,4 and 8 treatment were decreased in acupuncture group,with statistical differences(P<0.05).As compared with before treatment,all 5 factors scores after 2,4 and 8 treatment were decreased in western medicine group,with statistical differences(P<0.05).Comparison of HAMD factors between two groups,the anxiety and somatic symptom scores after 4 and 8 weeks treatmentin acupuncture group were lower than those in western medicine group at the same period,with statistical differences(P < 0.05).The cognitive disorder score after 8 weeks treatment in acupuncture group were lower than that in western medicine group at the same period,with statistical differences(P<0.01).The sleep disorder score 8 weeks after treatment was lower than that in western medicine group,with statistical differences(P<0.05).There were no statistical differences on the other two factors 8 weeks after treatment between two groups(P>0.05).4 There were statistical differences on the decreased score of HAMD after 2 and 8 weeks treatment between two groups(P<0.05);there were no statistical differences on the decreased score of HAMD after 4 weeks treatment between two groups(P>0.05).5 The total scores of BI after 4,8 weeks treatment were improved in two groups,with statistical differences(P<0.05).The total scores of CSS after 4,8 weeks treatment were improved in two groups,with statistical differences(P< 0.05).There were no statistical differences on the total scores of BI and CSS after 4 weeks treatment between two groups(P>0.05).The total score of BI after 8 weeks treatment in acupuncture group was superior to that in western medicine group,with statistical differences(P<0.05).The total score of CSS after 8 weeks treatment in acupuncture group was lower than that in western medicine group,but with no statistical differences(P>0.05).Conclusions: Governor Meridian-regulating and brain-unblocking acupuncture combined with rehabilitation training has exact effect on PSD,can effectively decrease the HAMD score,has better effects on the improvements of anxiety and somatic symptom,cognitive function and sleep disorders,with characteristic of operate and less adverse reaction,and also can promote the activity of daily living and neurologic impairments,which indicate that this TCM therapy can comprehensive improve PSD symptoms,safe and effective,worthy of clinical popularization and application. |
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