Therapeutic Effect Of Low-frequency RTMS Combined With "Zhi-san-zhen" On Post-stroke Depression Of Syndrome Of Stagnation Of Liver Qi

Objective:Through P300 incubation period,Hamilton depression scale(HAMD)and TCM syndrome scale,observe repeated transcranial magnetic stimulation(r TMS)combined with "zhi-san-zhen" and r TMS in the treatment of post-stroke depression of syndrome of stagnation of liver qi effect difference.And seek the treatment mechanism in PSD by combining clinical observation index and analysis of "zhi-san-zhen" and r TMS,so that explore the "zhi-san-zhen" whether there is any efficiency enhancement to the r TMS or not.Methods:60 patients with post-stroke depression of syndrome of stagnation of liver qi were involved in this research and randomly divided into the group of control group and experimental group in Fu Zhou Second Hospital during January 2020 to January 2022.There were 30 cases in each group.The control group was treated with 1Hz repeat r TMS in the right dorsolateral prefrontal cortex only for 1 month(30 days);The experimental group stabbed the patient with "zhi-san-zhen" on the basis of the control group for 1 month(30 days).The P300 incubation period,HAMD scale and TCM syndrome score scale were recorded in all patients before and after treatmentResult:1.There were differences in P300 latency before treatment(p<0.05),while there were no significant differences in HAMD and TCM syndrome scores(p>0.05).2.The incubation period of P300 was shortened after treatment than before treatment,with a significant difference before and after treatment(p<0.05);The HAMD scale and TCM syndrome scale scores were also lower compared with before treatment,and the difference was statistically significant before and after treatment(p<0.05).3.The treatment effect of the two groups evaluated by the TCM syndrome scale found that the recovery rate of the control group was3.4%,the development efficiency was 27.6%,the response rate was 65.5%,the inefficiency was 3.4%(result retains 1 decimal place),after rank sum test,the results significant significant between experimental and control groups(p<0.01);The recovery rate in the experimental group was 32.1%,the development efficiency was 50.0%,the response rate was 17.9%,the inefficiency is 0%(result retains 1 decimal place),after rank sum test,the results significant significant between experimental and control groups(p<0.01).4.The difference in P300 latency,HAMD score,and TCM syndrome score before and after treatment in the experimental group were greater than that of the control group.The differences between the groups were significantly significant(p<0.05).5.We found that Pearson’s correlation coefficient was 0.062 and the significance test result p=0.648> 0.05.Note that there was no correlation between pre-treatment P300 latency and pre-treatment HAMD scale score after correlation analysis was performed on the pre-treatment HAMD scale score and the P300latency;The correlation analysis between P300 latency difference and HAMD scale before and after treatment found that Pearson correlation coefficient was 0.281 and significance test result p=0.034 <0.05.It showed a correlation between P300 latency difference and HAMD scale score difference,since the Pearson correlation coefficient was between 0.2 and0.4;Correlation analysis of pre-treatment TCM syndrome scale score and P300 latency found Pearson correlation coefficient of 0.149 and significance test result p=0.269> 0.05.Note that there was no correlation between P300 latency and P300 latency and TCM syndrome scale score found Pearson correlation coefficient of 0.598 and significance test result p <0.0001.It shows that there is a significant correlation between the P300 incubation period difference and the TCM syndrome score scale before and after treatment,because the Pearson’s correlation coefficient between 0.4 and 0.7 indicates a moderate positive correlation.6.Intentionality analysis and side reaction of detached patients found that three patients in the two groups fell off.The cause of shedding after intentionality analysis had nothing to do with the experiment,and all patients could complete the experiment well and had good compliance.In terms of side reactions,there were no adverse events occurring in all the cases,which proved the good safety profile of either acupuncture,r TMS or the combination of the two.Conclusion:1.Low-frequency r TMS stimulation of the right dorsolateral prefrontal area and wisdom three needle combined with right r TMS stimulation of the right prefrontal area of the dorsolateral area can shorten the P300 latency and reduce the HAMD scale and TCM syndrome scale scores in PSD patients,with considerable potential in the treatment of post-stroke depression.2”zhi-san-zhen”has a significant synergistic effect in improving depressive symptoms for r TMS in treating PSD.3.The P300 has some potential for the supplementary diagnosis of PSD disease and the evaluation of the treatment effect.