Observation On Therapeutic Effect Of Acupuncture And Moxibustion For Depression Post-Stroke

ObjectiveTo explore the clinical efficacy and safety of acupuncture for patients with depression post-stroke, this randomized-controlled trial was undertaken.MethodsIn this study, objects were patients who had depression post-stroke. Test group (catgut implantation at acupoint, basic treatment and conventional acupuncture) and control group (basic treatment and conventional acupuncture, not catgut implantation).there were 30 patients in each group.Basic treatment:(1) All patients received general therapy of stoke such as controlling blood pressure and glucose. (2) All patients were treated with general therapy for rehabilitation post-stroke (select points of the disease part). Upper limb:Jianyu, Quchi, Sousanli and Hegu. Lower limb: Huantiao, Biguan, Futu, Zusanli,Jiexi and Taichong. Head acupuncture:opposite side parietotemporal linea oblique anterior. (3) All patients undertook active or passive functional exercise, including joints and muscle activity of patients'paralysis limbs. (4) All patients were needled in Shuigou, Neiguan both, Shenmen both, Taichong both; Shuigou used sparrow-pecking reduction technique, Shenmen used moderate reinforcement-reduction technique, Neiguan and Taichong used reduction technique, each point used technique for one minute and once every five minutes and remained for thirty minutes.Group therapy:(1) catgut implantation at acupoint:syndrome of stagnation of liver qi:Xinshu, Ganshu, Feishu and Shenshu, both sides; syndrome of deficiency of heart and spleen:Xinshu, Pishu, Feishu and Shenshu, both sides. (2) Operation of catgut implantation at acupoint:disinfected routinely the skin, cut the 000 number medical catgut into 1 cm equal section, then put those sections into 75% alcohol about 30 minutes for use, and took the catgut to thread pinhead of 7 number needle, then inserted the pinhead into point directly about 30 mm, after obtained qi by lifting and thrusting, used the stylet to withstand the catgut (stylet was transformed by cutting the filiform needle with diameter of 0.3mm and length of 40mm to flat end), slowly exited the needle, and remained the catgut in the point, at last spread steilitas cotton ball and fixed with rubber cement. Patients received the therapy once a week. While the control group merely receive basice and routine acupuncture and moxibustion therapy, without catgut implantation treatment. Any other drugs had therapeutic effect were forbidden to take. The routine treatment of acupuncture and moxibustion was conducted five times every week in both groups. A course consisted of three weeks and total two courses were performed.ResultsTotally,60 qualified cases were recruited in this randomi zed-control led clinical trial. There were 30 cases in trial group and 30 cases in control group.Group comparability test:before treatment, all indices in both groups had no significant difference, which indicated the baseline of two groups was comparable. Efficacy comparison:The trial group's clinical recovery rate was 46.67%, excellence rate was 30%, effective rate was 13.33%, and total effective rate was 90%; while the control group's rate was 40%,30%,16.67%, and 86.67% relatively. Compared with efficacy of Chinese syndrome between two groups, there was no significant difference. Comparison with the change condition of depression, pessimistic, restlessness, insomnia, there was no significant difference before and after treatment in two groups. Before treatment, comparison with scores of HAMD scale in two groups showed no statistic significance, which was comparable. While there had significant difference of improvement condition of HAMD scale scores after treatment in the trial group (t=21.92, P=0.00) and the control group (t=21.93,P=0.00) by comparing with scores of pre-treatment. After treatment, comparison with accumulated points of HAMD scale scores showed statistical significance between two groups (t=9.23, P=0.00). The difference value of HAMD scale scores in both groups showed statistic significance(t=2.92, P=0.004)after treatment. Before treatment, comparison with neurologic impairment degree score between two groups had no statistical significance, indicating comparability exist. While compared the improvement condition of neurologic impairment degree score after treatment with that before treatment in the trial group, had significance statistically (t=16.45, P=0.00); and had significant difference in the control group (t=16.43, P=0.00) as well. Moreover, after treatment, comparison with the improvement condition of neurologic impairment degree score between two groups had statistical significance (t=3.61, P=0.00). Before treatment, comparison with score of daily activity function between two groups had no statistic significance(t=0.22, P=0.82), suggesting comparability exist. While compared the improvement condition of daily activity function score after treatment with that before treatment in the trial group, had significance statistically (t=16.45, P=0.00); and had significant difference in the control group (t=16.43, P=0.00) as well. Moreover, after treatment, comparison with the improvement condition of daily activity function score between two groups had statistical significance (t=3.61, P=0.00)Safety test:before and after treatment, the blood routine, urine routine, stool routine, liver and kidney function, electrocardiogram in both groups all showed no abnormality.Adverse evens observation:there was no adverse reaction in both groups after treatment.ConclusionsAcupuncture and moxibustion assisting with catgut implantation method for depression post-stroke had equal efficacy as ordinary acupuncture and moxibustion, while the former was better on improving patients'quality of life.