2023 年第 9 期 第 18 卷

疏肝调神针刺法联合渐进式肌肉放松训练治疗脑梗死后抑郁的临床效果

Clinical effect of Shugan Tiaoshen acupuncture combined with progressive muscle relaxation training on the treatment of depression after cerebral infarction

作者：陈绚雅王小桥赵灿

英文作者：Chen Xuanya Wang Xiaoqiao Zhao Can

单位：海南省人民医院海南医学院附属海南医院康复医学科，海口570311

英文单位：Department of Rehabilitation Medicine Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical College Haikou 570311 China

关键词：脑梗死；抑郁；疏肝调神针刺法；肌肉训练

英文关键词：Cerebralinfarction;Depression;ShuganTiaoshenacupuncture;Muscletraining

• 摘要：

• 目的  探讨疏肝调神针刺法联合渐进式肌肉放松训练治疗脑梗死后抑郁的效果。方法 选择2020年1月至2022年1月海南省人民医院收治的96例脑梗死后抑郁患者，按照随机数字表法将患者分为对照组和观察组，每组48例。2组患者均接受常规药物治疗，在此基础上对照组采用渐进式肌肉放松训练治疗，观察组采用疏肝调神针刺法联合渐进式肌肉放松训练治疗，2组均治疗8周。比较2组治疗后总有效率、认知功能、心理状态、睡眠质量、血清学指标及不良反应发生情况。结果 观察组治疗后总有效率高于对照组［93.8%（45/48）比77.1%（37/48）,χ2=5.352，P=0.021］。治疗后2组简易智力状态检查量表（MMSE）、中文版蒙特利尔认知评估量表（MoCA）评分均高于治疗前（均P＜0.01），17项汉密尔顿抑郁量表（HAMD-17）评分、Zung抑郁自评量表（SDS）评分、匹兹堡睡眠质量指数量表（PSQI）评分和血清白细胞介素1β、白细胞介素6、C反应蛋白水平均低于治疗前（均P＜0.01）。观察组治疗后MoCA评分、MMSE评分均高于对照组（均P＜0.01），HAMD-17评分、SDS评分、PSQI评分和血清白细胞介素1β、白细胞介素6、C反应蛋白水平均低于对照组（均P＜0.01）。2组不良反应发生率比较差异无统计学意义（χ2=1.044，P=0.307）。结论 在常规药物治疗基础上，疏肝调神针刺法联合渐进式肌肉放松训练可以更有效地抑制炎症反应，改善抑郁症状、认知功能和睡眠质量。

• Objective To investigate the clinical effect of Shugan Tiaoshen acupuncture combined with progressive muscle relaxation training on the treatment of depression after cerebral infarction. Methods From January 2020 to January 2022, 96 patients with depression after cerebral infarction admitted to Hainan General Hospital were selected, and they were divided into control group and observation group according to random number table method, with 48 cases in each group. Patients were treated with conventional drugs in the two groups, on this basis, the control group was treated with progressive muscle relaxation training, and the observation group was treated with Shugan Tiaoshen acupuncture combined with progressive muscle relaxation training, with 2 courses of treatment in two groups. The effective rate, cognitive function, psychological status, sleep quality, serological indicators and adverse reactions were compared in the two groups. Results After treatment, the effective rate in the observation group was higher than that in the control group ［93.8%（45/48） vs 77.1%（37/48）, χ2=5.352, P=0.021］. The scores of mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) Chinese version after treatment were both higher than those before treatment in the two groups (both P<0.01). The scores of 17 items of Hamilton depression scale (HAMD-17), Zung self-rating depression scale (SDS) and pittsburgh sleep quality index (PSQI) scale, and serum levels of interleukin-1β (IL-1β), IL-6 and C-reactive protein (CRP) after treatment were all lower than those before treatment in the two groups (all P<0.01). After treatment, the scores of MoCA and MMSE in the observation group were both higher than those in the control group (both P<0.01), the scores of HAMD-17, SDS and PSQI, and the serum levels of IL-1β, IL-6 and CRP in the observation group were all lower than those in the control group (all P<0.01). There was no statistically significant difference in incidences of adverse reaction between the two groups（χ2=1.044， P=0.307）. Conclusions  On the basis of conventional drug treatment, Shugan Tiaoshen acupuncture combined with progressive muscle relaxation training can more effectively inhibit inflammatory reaction, improve depressive symptoms, cognitive function and sleep quality.