【摘要】 背景:中医认为“头者,精明之府”,“头者,人之元首,人神之注”,故应用头电针治疗脑卒中后抑郁,可达到醒脑开窍、荡涤蒙蔽、疏通经络、开解抑郁的作用。目的:观察头电针对脑卒中后抑郁的治疗作用。设计:随机对照,单盲评估。单位:南方医科大学南方医院针灸科,广州中医药大学针灸推拿学院。对象:以南方医科大学附属南方医院、珠江医院和广州中医药大学第一附属医院门诊就诊的脑卒中后抑郁患者90例为观察对象,所有患者汉密顿抑郁量表评分>20分。90例患者随机分为头针组46例和常规针刺组44例。方法:常规针刺组患者取偏瘫侧的手足三阳经穴位为主进行治疗,穴位包括肩骨禺、臂臑、曲池、手三里、外关、合谷、髀关、梁丘、足三里、阳陵泉、昆仑、解溪,上述穴位分成2组,每日1组,交替使用,平补平泻,留针30min。连续治疗6d后,休息1d,共治6周。头针组患者除按上述方法治疗外,还加用头针。取顶中线、额中线、额旁1线(双),得气后连接G6805型电针仪(断续波、50Hz,4V),留针30min。连续治疗6d后,休息1d,共治6周。治疗前后应用汉密顿抑郁量表评估抑郁状态,中风病情评分评估脑卒中疗效。主要结局观察:两组患者治疗前后汉密顿抑郁量表评分和脑卒中疗效。结果:按意向处理分析,90例均进入结果分析。①汉密顿抑郁量表评分:头针组治疗后低于治疗前和常规针刺组治疗后(8.55±1.73,30.61±4.02,15.04±2.33,P<0.01)。②脑卒中疗效:两组总有效率无差异,但有趋势表明头针组好于常规针刺组(100%,98%,χ2=1.9167,P>0.05)。结论:头电针对脑卒中后抑郁有明显的治疗作用,抑郁症的改善对脑卒中的康复有一定促进作用。更多还原

【Abstract】 BACKGROUND: It is thought in traditional Chinese medicine that "the head is the residence of intelligence", "the head is the leader of body, and the focus of the spirit". Therefore, scalp electro-acupuncture can induce resuscitation, relieve mental confusion, dredge the meridian and eliminate the depression in treatment of post-stroke depression. OBJECTIVE: To observe the curative effect of head acupuncture on post-stroke depression. DESIGN: Randomized controlled and single blind evaluation SETTING: Department of Acupuncture and Moxibustion, Nanfang Hospital of Southern Medical University; College of Acupuncture and Massage, Guangzhou University of Traditional Chinese Medicine. PARTICIPANTS: Totally 90 patients with post-stroke depression were from Affiliated Nanfang Hospital and Zhujiang Hospital of Southern Medical University, First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine were recruited. The Score of all the patients in Hamilton Rating Scale for Depression (HRSD) were > 20. Ninety patients were randomly divided as scalp acupuncture group (n=46) and routine acupuncture group (n=44). METHODS: The patients in the routine acupuncture group were treated mainly at points of three-yang meridians of foot and hand at the hemiplegia side. The points include jianyu (LI-15) , binao (LI-14) , quchi (LI-11), shousanli (LI-10), waiguan (SJ-5), hegu (LI-4), biguan (St-31), liangqiu (St-34), zusanli (St-36), yanglingquan (GB-34), kunlun (UB-60), jiexi (St-41). The above points were divided into 2 groups, 1 group each day, alternately. Even reinforcing-reducing method was used, with 30-minute needle retention, 6 successive days treatment with 1 day rest, for 6 weeks totally. The patients in the scalp acupuncture were treated with, besides the above method, scalp acupuncture. Mid-parietal line, mid-frontal line, laterofrontal lineI(both sides)were chosen. After arrival of qi, G6805 type electro-acupuncture apparatus (interrupted wave, 50 Hz,4 V) was connected, with 30-minute needle retention, 6 successive days treatment with 1 day rest, 6 for 6 weeks totally.HRSD was used to evaluate the status of depression before and after treatment. Stroke score was used to evaluate the curative effect of stroke . MAIN OUTCOME MEASURES: HRSD scores and curative effect of apoplexy before and after treatment of the patients in two groups. RESULTS: According to the intention treatment, all 90 patients entered the result analysis. ① HRSD score after treatment was lower than that before treatment in the scalp acupuncture group,and that after treatment group in the routine acupuncture group (8.55±1.73,30.61±4.02,15.04±2.33,P < 0.01).②There was no significant difference of the total effective rate in the two groups , but some tendency indicated the effective rate in the scalp acupuncture group was better than that in the routine acupuncture group (100%,98%,χ2=1.9167,P > 0.05). CONCLUSION: Scalp electro-acupuncture has obvious curative effect on post-stroke depression. The amelioration of melancholia has a certain promoting effect on rehabilitation of apoplexy.更多还原