目的 探讨“通督治郁”针灸疗法对脑卒中后抑郁症(PSD)患者临床疗效及对血清5羟色胺(5-HT)、去甲肾上腺素(NE)和脑源性神经营养因子(BDNF)水平的影响.方法 通过对本院2014年5月～2016年4月住院部和门诊治疗的120例PSD患者临床资料做回顾性分析,并根据治疗方式的不同分为A组、B组、C组3组,(采用“通督治郁”针灸疗法治疗为A组、采取常规针刺治疗为B组、采取西药治疗为C组)各40例.比较并分析3组患者血清5-HT、NE和BDNF表达水平及治疗前后的治疗疗效.结果 3组患者经各自方案治疗后,HAMD评分均较治疗前改善,差异具有统计学意义(P＜0.05),且治疗后A组HAMD评分明显低于B组和C组,差异具有统计学意义(P＜0.05),但治疗后B组和C组HAMD评分比较差异无统计学意义(P＞0.05).3组患者治疗前NE、5-HT、BDNF水平含量比较差异均无统计学意义(P＞0.05),经治疗后三组患者NE、5-HT、BDNF水平含量均较治疗前上升(P＜0.05),且治疗后A组NE、5-HT、BDNF水平含量均明显高于B组、C组(P＜0.05),但B组和C组NE、5-HT、BDNF水平含量比较差异无统计学意义(P＞0.05).3组患者经各自方案治疗后A组抑郁症状改善总有效率(90.00％)明显高于B组(65.00％)、C组(60.00％),差异具有统计学意义(P＜0.05),但B组和C组总有效率比较(65.00％/60.00％),差异无统计学意义(P＞0.05).结论 “通督治郁”针灸疗法在可显效地改善PSD患者抑郁症状,且可明显地提高PSD患者血清中的NE、5-HT、BDNF的表达水平.%Objective To investigate the clinical effect of "Tong Du Zhi Yu" acupuncture and moxibustion therapy on post-stroke depression (PSD) patients and their effects on serotonin (5-HT),norepinephrine (NE) and brain-derived nerve (BDNF) levels.Methods The clinical data of 120 patients with PSD were retrospectively analyzed.The patients were divided into group A,B and C according to the different treatment methods.The group A was treated with acupuncture and moxibustion.The group B was treated with routine acupuncture.The group C was treated with western medicine.The levels of serum 5-HT,NE and BDNF were compared before and after the treatment.Results HAMD scores of the three groups were improved after treatment (P＜0.05).HAMD score of group A was significantly lower than that of group B and group C after treatment (P＜0.05).No significant difference was detected in HAMD score between group B and group C after treatment (P＞0.05).The total effective rate of group A (90.00％) was significantly higher than that of group B (65.00％) and group C (60.00％) (P＜0.05).No significant difference was detected in the total effective rate between group B and group C (65.00％/60.00％) (P＞0.05).No significant differences was detected in NE,5-HT and BDEF levels among the three groups before treatment (P＞0.05).The levels of NE,5-HT and BDEF in the three groups after treatment were higher than those before treatment (P＜0.05).The levels of NE,5-HT and BDEF in group A were significantly higher than those in group B and C (P＜0.05).No significant differences were detected in NE,5-HT and BDEF levels between group B and group C (P＞0.05).Conclusion "Tong Du Zhi Yu" acupuncture therapy can significantly improve depressive symptoms in PSD patients,and significantly improve the serum levels of NE,5-HT and BDEF in PSD patients.
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