摘要
目的:探讨通督解郁针法结合通窍解郁汤治疗脑卒中后抑郁的疗效及对神经递质的影响。方法:选取2021年1月—2023年12月北京中医医院顺义医院脑病科收治的108例脑卒中后抑郁患者,随机分为对照组和观察组,每组54例。对照组给予常规西药治疗,观察组给予通督解郁针法结合通窍解郁汤治疗,比较两组治疗前后中医证候积分、抑郁程度及睡眠质量情况;采用可重复的成套神经心理状态测验(RBANS)对两组治疗前后认知功能进行评价;比较治疗前后两组多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)变化情况。比较两组治疗前后生活质量情况;比较两组疗效情况。结果:治疗后,两组中医证候积分、HAMD评分、PSQI指数降低(P<0.05),观察组更明显(P<0.05)。治疗后,两组RBANS评分升高(P<0.05),且观察组比对照组高(P<0.05)。治疗后,两组DA、NE、5-HT水平升高(P<0.05),观察组更明显(P<0.05)。观察组治疗有效率及生活质量优于对照组(P<0.01)。结论:通督解郁针法结合通窍解郁汤治疗脑卒中后抑郁,可缓解患者抑郁程度,改善睡眠质量及认知功能,调节其血清神经递质水平,进而提高其生活质量。
Objective:To explore the efficacy of the Tongdu Jieyu acupuncture method combined with the Tongqiao Jieyu decoction in treating post-stroke depression and its effects on neurotransmitters.Methods:A total of 108 patients with post-stroke depression,admitted to the Department of Encephalopathy at Shunyi Hospital,Beijing Hospital of Traditional Chinese Medicine from January 2021 to December 2023,were randomly divided into a control group and an observation group,with 54 cases in each group.The control group received conventional Western medication,while the observation group was treated with the Tongdu Jieyu acupuncture method combined with the Tongqiao Jieyu decoction.Both groups were evaluated for changes in traditional Chinese medicine(TCM)syndrome scores,depression severity,and sleep quality before and after treatment.Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)test.Changes in dopamine(DA),norepinephrine(NE),and serotonin(5-HT)levels were compared between the two groups.Quality of life and treatment efficacy were also evaluated.Results:After treatment,both groups showed a significant decrease in TCM syndrome scores,HAMD scores,and PSQI index(P<0.05),with the observation group showing more significant improvement(P<0.05).The RBANS scores increased in both groups(P<0.05),and the observation group had higher scores than the control group(P<0.05).Both groups showed increased levels of DA,NE,and 5-HT after treatment(P<0.05),with the observation group showing more pronounced changes(P<0.05).The observation group had a higher treatment efficacy rate and better quality of life compared to the control group(P<0.01).Conclusion:The Tongdu Jieyu acupuncture method combined with the Tongqiao Jieyu decoction can alleviate depression,improve sleep quality and cognitive function,regulate serum neurotransmitter levels,and enhance the quality of life in patients with post-stroke depression.
作者
刘晶晶
张小健
郝春波
刘宏伟
焦雪蕾
周媛
LIU Jingjing;ZHANG Xiaojian;HAO Chunbo;LIU Hongwei;JIAO Xuelei;ZHOU Yuan(Department of encephalopathy,Shunyi Hospital,Beijing Hospital of Traditional Chinese Medicine,Beijing 101300,China)
出处
《中医药学报》
2025年第5期79-83,共5页
Acta Chinese Medicine and Pharmacology
基金
北京市属医院科研培育计划项目(PZ2022015)
第六批北京市级中医药专家学术经验继承项目。
关键词
卒中后抑郁
通督解郁针
通窍解郁汤
神经递质
认知功能
Post-stroke depression
Tongdu Jieyu acupuncture
Tongqiao Jieyu decoction
Neurotransmitters
Cognitive function
