解郁方口服联合针刺治疗卒中后抑郁的临床研究
Effect of Jieyu Decoction Combined with Acupuncture in the Treatment of Post-stroke depression:A Randomized Clinical Trial
- 北京中医药 2022年41卷第9期 页码：1044-1048
- 作者机构：
1.上海中医药大学附属上海市中西医结合医院脑病科，上海 200082
2.上海市嘉定区南翔医院神经内科， 上海 201802
3.上海中医药大学附属龙华医院急诊科，上海 200032
- 作者简介：
游毅，男，38岁，硕士，主治医师。研究方向：脑卒中及其并发症的中医药防治。
王长德，E-mail： wangch_de@163.com
- 基金信息：上海市虹口区医学科研课题（虹卫1702-03）;上海市虹口区国医强优建设项目(HGY-YSZK-2018-10);上海市中西医结合医院首届骨干青年医师培养计划项目(RCPY0032)
DOI：10.16025/j.1674-1307.2022.09.025
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游毅，王利，朱乐萍，等.解郁方口服联合针刺治疗卒中后抑郁的临床研究［J］.北京中医药，2022，41（9）：1044-1048.
YOU Yi,WANG Li,ZHU Le-ping,et al.Effect of Jieyu Decoction Combined with Acupuncture in the Treatment of Post-stroke depression:A Randomized Clinical Trial[J]. Beijing Journal of Traditional Chinese Medicine,2022,41(09):1044-1048.
游毅，王利，朱乐萍，等.解郁方口服联合针刺治疗卒中后抑郁的临床研究［J］.北京中医药，2022，41（9）：1044-1048. DOI： 10.16025/j.1674-1307.2022.09.025.
YOU Yi,WANG Li,ZHU Le-ping,et al.Effect of Jieyu Decoction Combined with Acupuncture in the Treatment of Post-stroke depression:A Randomized Clinical Trial[J]. Beijing Journal of Traditional Chinese Medicine,2022,41(09):1044-1048. DOI： 10.16025/j.1674-1307.2022.09.025.
摘要
目的,2,观察解郁方口服联合针刺治疗卒中后抑郁的临床疗效。,方法,2,选取2017年—2021年上海中医药大学附属上海市中西医结合医院脑病科收治的卒中后抑郁患者76例，随机分为观察组、对照组各38例。对照组在常规治疗基础上给予氟西汀胶囊20 mg，1次/d口服；观察组在常规治疗基础上给予解郁方口服+针刺治疗。2组均连续治疗4周。治疗前后采用汉密顿抑郁量表17项（HAMD⁃17）评分、抑郁自评量表（SDS）评分评价抑郁程度，美国国立卫生研究院卒中量表（NIHSS）评分评价神经缺损程度，日常生活量表（ADL）评分评价日常生活能力；采用ELISA法检测血清白介素（IL）⁃1、IL⁃6；检测血常规、尿常规、肝肾功能、心电图，统计临床不良反应。同时引入效应量指标Cohen's d作为效果指标。,结果,2,治疗后，2组HAMD⁃17评分、SDS评分、NIHSS评分较治疗前均降低，观察组明显优于对照组（,P,<,0.05），HAMD⁃17评分、NIHSS评分具有中等效应（0.5,<,Cohen's d,<,0.8），SDS评分具有高等效应（Cohen's d=0.8）；2组ADL较治疗前均有升高，观察组明显优于对照组（,P,<,0.05），具有中等效应（0.5,<,Cohen's d,<,0.8）。观察组临床疗效总有效率为89.74%，优于对照组的76.32%（,P,<,0.05）；2组血清IL⁃1、IL⁃6水平较治疗前均有降低，观察组优于对照组（,P,<,0.05），具有中等效应（0.5,<,Cohen's d,<,0.8）。治疗期间，2组均未见严重不良反应，治疗后安全指标均未出现明显异常。,结论,2,解郁方口服联合针刺能促进卒中患者神经功能恢复，且能改善卒中后抑郁，其作用机制可能与调节血清IL⁃1、IL⁃6水平有关。
Abstract
Objective,2,To observe the clinical effect of Jieyu Prescription combined with in the treatment of post-stroke depression and neural functional recovery for Ischemic Stroke.,Methods,2,76 patients with post-stroke depression were randomly divided into treatment group（,n,=38）and control group（,n,=38）.The treatment group was treated with Jieyu formula plus acupuncture on the basis of conventional treatment，while the control group was treated with fluoxetine Capsule on the basis of conven-tional treatment for 4 weeks.The changes of HAMD⁃17 scale，SDS scale，NIHSS score，ADL scale，serum IL⁃1 and IL⁃6 were detected before and after treatment.,Results,2,After treatment，HAMD⁃17 scale，SDS scale and NIHSS scores of the two groups were lower than before treatment，the treatment group was significantly better than the control group（,P,<,0.05），with moderate effect（0.5,<,Cohen's D effect,<,0.8），SDS scale with higher effect（Cohen's D effect=0.8）；ADL scale of the two groups were higher than before treatment，the treatment group was significantly better than the control group（,P,<,0.05），with moderate effect（0.5,<,Cohen's D effect,<,0.8）.The total effective rate of the treatment group was 89.74%，which was better than 76.32% of the control group（,P,<,0.05）；the plasma concentrations of IL⁃1 and IL⁃6 in the two groups were lower than before treatment，and the treatment group was significantly better than the control group（,P,<,0.05），with moderate effect（0.5,<,Cohen's D effect,<,0.8）.,Conclusion,2,Jieyu formula combined with acupuncture can promote the recovery of neurological function in patients with ischemic stroke and improve post-stroke depression.Its mechanism may be related to the regulation of plasma IL⁃1 and IL⁃6 concentrations.
关键词
针刺解郁方缺血性卒中抑郁
Keywords
acupunctureJieyu Decoctionpost-ischemic stroke depressionIL⁃1IL⁃6
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