The Clinical Efficacy Evaluation Of TiaoShen-KaiQiao Acupuncture In Patients With Ischemic Post-Stroke Depression And Its Effect On Relevant Inflammatory Indexes

Purpose:1.A randomized,single-blind,placebo-controlled clinical trial was conducted to compare the clinical efficacy of Tiao Shen-Kai Qiao acupuncture with that of the western antidepressant fluoxetine hydrochloride in the treatment of ischemic post-stroke depression?PSD?.2.The possible mechanism of acupuncture treatment for PSD was investigated by observing the changes of inflammatory indicators such as leukocyte,platelet,NLR?neutrophils/lymphocytes?,PLR?platelet/lymphocytes?in peripheral blood of patients with post-stroke depression before and after treatment.Method:The 128 PSD patients who met the standard were randomly divided into the experimental group of 65 patients and the control group of 63 patients.Patients in both groups were given basic treatment for ischemic stroke.On this basis,the experimental group was given acupuncture therapy combined with oral placebo,while the control group was given fluoxetine hydrochloride combined with limb acupuncture.Both groups received acupuncture treatment 3times each week,and oral placebo or fluoxetine 20mg/d for 4 weeks.All subjects were evaluated by Hamilton depression scale?HAMD-17?Barthel index?BI?and depression self-rating scale?SDS?before and 4 weeks after treatment.The blood routine examination was completed before treatment and 4 weeks after treatment,and the values of leukocyte platelet NLR?neutrophils lymphocytes?PLR?platelet lymphocytes?in blood routine were statistically analyzed,to explore the possible therapeutic mechanism of acupuncture therapy for PSD.Result:1.Baseline informationThere was no statistically significant difference between the two groups in the general information such as gender,age,disease course,weight and the score of HAMD-17,BI,SDS scale?P>0.05?,indicating that the two groups were comparable.2.Total clinical efficiencyAfter 4 weeks of treatment,the experimental group showed 1 effective case,7 effective cases,31 improved cases,26 invalid cases,the total effective rate was 60%.In the control group,there were 1 cases of obvious effect,9 cases of effective effect,19 cases of improvement,and34 cases of ineffective effect,The total efficiency is 46.04%.There was no statistically significant difference in the clinical efficacy between the two groups?P>0.05?,indicating that the improvement of depression symptoms in PSD patients was equivalent to that in the combination of tiao-acupuncture combined with placebo and fluoxetine hydrochloride combined with limb acupuncture.3.Scale score comparison3.1 HAMD-17 scoreThere was no statistically significant difference between the two groups in the hamd-17scale before treatment?P>0.05?,indicating that the two groups were comparable.4 weeks after treatment,the treatment group and control group scores are relatively lower than baseline,the compare inside of each way has significant difference were observed in the comparison test statistical significance(P_experiment<0.01,P_contrast<0.01).Comparison between groups,comparing differences between experimental group and control group after treatment group has no statistical significance?P>0.05?,the results show that both groups can significantly improve symptoms of depression in patients with PSD.3.2 HAMD scale related certification score3.2.1 HAMD-Gastrointestinal symptoms scoreThere was no statistically significant difference in the gastrointestinal symptoms score between the two groups before treatment?P>0.05?,suggesting that the two groups were comparable.After 4 weeks of treatment,the difference between the experimental group before and after treatment was statistically significant?P<0.01?,the difference between the control group before and after treatment was not statistically significant?P>0.05?;the difference between the groups was statistically significant?P<0.05?.This result shows that the acupuncture combined with acupuncture combined with placebo can better improve gastrointestinal symptoms such as decreased appetite and defecation disorders in patients with fluoxetine combined with body acupuncture.3.2.2 HAMD-Systemic Symptom ScoreThere was no statistically significant difference in the systemic symptom score between the two groups before treatment?P>0.05?,suggesting that the two groups are comparable.After4 weeks of treatment,the systemic symptom score of the test group decreased compared with that before the treatment,and the difference was statistically significant?P<0.05?.The difference of the systemic symptom score of the control group before and after treatment was not statistically significant?P>0.05?.Compared between groups,the score of the test group was lower than that of the control group,and the difference was statistically significant?P>0.05?.This result shows that the Tiao Shen Kaiqiao acupuncture combined with placebo can better relieve the back pain of the limbs of PSD patients than the fluoxetine combined with body acupuncture,and it has advantages in improving systemic symptoms such as fatigue.3.3 BI scoreThere was no statistically significant difference between the two groups of patients before treatment?P>0.05?,indicating that the two groups were comparable.After 4 weeks of treatment,the BI score of the experimental group and the control group were respectively increased compared with the baseline before treatment,and the difference was statistically significant(P_experiment<0.01,P_contrast<0.05).There was no statistically significant difference between the experimental group and the control group?P>0.05?,indicating that the combination of tiao shen kai qiao acupuncture combined with placebo and fluoxetine hydrochloride combined with acupuncture could improve the dail.y living and activity ability of PSD patients.3.4 SDS scoreThere was no significant difference in SDS scale between the two groups before treatment?P>0.05?,indicating the two groups were comparable.After 4 weeks of treatment,SDS scores in both the experimental group and the control group decreased from the baseline,and the differences between the two groups were statistically significant(P_experiment<0.01,P_contrast<0.01),indicating that treatment in both groups could significantly improve depressive symptoms in PSD patients.After treatment,there was no statistically significant difference in SDS score between the two groups?P>0.05?,indicating that the two groups had similar improvement in SDS depression score.4 Comparison of inflammatory markers in peripheral blood4.1 HemamebaThere was no statistically significant difference in leucocyte level between the two groups before treatment?P>0.05?,suggesting that the two groups were comparable.After 4 weeks of treatment,the white blood cell content of the experimental group and the control group did not change significantly from the baseline before treatment and the difference was not statistically significant(P_experiment>0.05,P_contrast>0.05).There was no statistically significant difference in leukocyte content between the experimental group and the control group after treatment?P>0.05?.The results indicated that the two treatments had no significant effect on the leucocyte content.4.2 Blood plateletThere was no statistically significant difference in platelet content between the two groups before treatment?P>0.05?,suggesting that the two groups were comparable.After 4 weeks of treatment,the platelet content in the experimental group and the control group did not change significantly compared with the baseline before treatment,and the differences between the two groups were not statistically significant(P_experiment>0.05,P_contrast>0.05).There was no statistically significant difference in platelet content between the experimental group and the control group after treatment?P>0.05?.It was suggested that the two treatments had no significant effect on the platelet content in peripheral blood of PSD patients before and after treatment.4.3 NLRBefore treatment,there was no statistically significant difference between the two groups in the NLR group?P>0.05?,suggesting that the two groups were comparable.After 4 weeks of treatment,the NLR value of the experimental group decreased after treatment,and the difference was statistically significant compared with the baseline before treatment?P<0.01?,suggesting that the method of mind-adjusting and orifice acupuncture can significantly reduce the NLR value of patients with PSD.There was no statistically significant difference in NLR before and after treatment in the control group?P>0.05?.There was statistically significant difference in NLR between the experimental group and the control group after 4 weeks of treatment?P<0.05?.4.4 PLRBefore treatment,there was no statistically significant difference between the two groups in PLR group?P>0.05?,suggesting that the two groups were comparable.After 4 weeks of treatment,the PLR value of the experimental group and the control group decreased compared with the baseline before treatment,but the difference was not statistically significant?P>0.05?.Comparison between the two groups showed no statistically significant difference between the two groups after 4 weeks of treatment?P>0.05?,suggesting that the two treatments had little effect on the PLR value of PSD patients.Conclusion:1.The therapeutic effect of Tiao Shen-Kai Qiao acupuncture for treating post-ischemic stroke depression is accurate and comparable to fluoxetine hydrochloride.2.Tiao Shen-Kai Qiao Acupuncture combined with placebo and fluoxetine hydrochloride combined with acupuncture can significantly reduce the HAMD-17,SDS score of patients with post-ischemic stroke depression,improve their depressive symptoms,and improve the BI index score and the ability to perform daily activities.In addition,compared with fluoxetine combined with body acupuncture,acupuncture combined with placebo can improve gastrointestinal symptoms such as loss of appetite and defecation disorders in PSD patients.Systemic symptoms such as fatigue are more advantageous.3.Tiao Shen-Kai Qiao Acupuncture with mind-adjusting and orifice technique can significantly reduce the level of NLR in peripheral blood of patients with post-ischemic stroke depression,but has no significant effect on the level of white blood cells,platelets and PLR.It is preliminarily speculated that the possible therapeutic mechanism of acupuncture therapy for PSD is to reduce the level of NLR and improve the inflammatory state in patients,thus exerting the antidepressant effect.