本文選題：腦卒中后抑郁癥　切入點(diǎn)：艾灸療法　出處：《南京中醫(yī)藥大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 中風(fēng)后抑郁癥(Post Stroke Depression,PSD)系一種繼發(fā)性抑郁,是腦血管常見的并發(fā)癥之一。而世界衛(wèi)生組織(WHO)亦指出,精神性疾病是21世紀(jì)人類將要面臨的主要疾患。中風(fēng)后抑郁癥(PSD)包括多種精神癥狀和軀體癥狀的復(fù)雜的情感障礙性疾病。臨床上主要表現(xiàn)為情緒低落、睡眠障礙、興趣減退、易疲勞、思維遲緩、食欲減退、悲觀絕望,甚則出現(xiàn)自殺企圖和行為異常等癥狀。臨床上如能及時(shí)診斷并予以有效的治療,可降低患者致殘率和死亡率,提高其生活質(zhì)量。目前西藥治療該病主要采用5-HT重?cái)z取抑制劑(SSRI),公認(rèn)有效,但該藥存在著消化神經(jīng)等系統(tǒng)的副作用,例如：惡心、嘔吐、消化不良、嗜睡、性功能障礙等,且價(jià)格昂貴,使患者難以接受,依從性差。而中醫(yī)對(duì)本病的治療和延緩其病勢發(fā)生發(fā)展具備一定優(yōu)勢。因此中醫(yī)各種治療手段治療中風(fēng)后抑郁的證候及療效機(jī)理相關(guān)研究,已引起國內(nèi)外學(xué)者的普遍關(guān)注。其中灸法對(duì)該病的治療效果較好,無副作用,而且收效較快,在腦血管疾病的治療中日益發(fā)揮出其優(yōu)越性。 治療方法： 受試對(duì)象來源于2010年3月至2011年3月在南京中醫(yī)藥大學(xué)附屬江蘇省中醫(yī)院神經(jīng)內(nèi)科病房或門診并符合納入病例標(biāo)準(zhǔn)的中風(fēng)后抑郁癥患者,一共納入60例分為兩組：治療組與對(duì)照組個(gè)30例。 治療組以艾灸結(jié)合百憂解治療,對(duì)照組以百憂解治療。治療組灸法取背俞穴的心俞,肝俞,脾俞,腎俞采用隔姜灸方法。再取神闕進(jìn)行溫和灸加強(qiáng)肝脾腎功能,并減緩百憂解的常見副作用。另外,口服藥物：參照藥物說明書,給予百憂解維持劑量口服20mg/d,藥物于清晨口服。每日一次,15次為1療程,共進(jìn)行3療程。對(duì)照組,口服藥物：按照藥物說明書治療劑量予患者口服藥物百憂解,前15天口服20mg/d,后改為40mg/d,藥物均于清晨口服。每日一次,15次為1療程,共進(jìn)行3療程。 結(jié)果： 1.兩組一般資料經(jīng)過t檢驗(yàn),P0.05,沒有顯著性差異,具有可比性。 2.漢密爾頓抑郁量表：兩組治療后總有效率經(jīng)X2檢驗(yàn),雖無顯著性差異但治療組總有效率(83.3%)明顯優(yōu)于對(duì)照組(73.33%)。 3.《中風(fēng)后抑郁癥針灸治療評(píng)定量表》：經(jīng)過治療,兩組患者雖均獲得良好療效,但治療組的總有效率(86.66%)明顯優(yōu)于對(duì)照組(66.67%)。因此得出結(jié)論,艾灸結(jié)合百憂解治療PSD效果優(yōu)于單用百憂解治療PSD。 4.TESS副反應(yīng)量表：3療程結(jié)束后,治療組TESS評(píng)分為(3.7±1.5),而對(duì)照組TESS評(píng)分為(15.8±4.4),分值明顯高于治療組(P值0.05)。因此得出結(jié)論,艾灸可以控制并減少百憂解帶來的副作用,因此改善患者的生活狀態(tài)。 結(jié)論： 艾灸結(jié)合百憂解與單一使用百憂解治療PSD均能起到較好的療效,兩者比較之下,艾灸與藥物結(jié)合治療PSD的療效顯得更佳,且起效時(shí)間來的短而具有持續(xù)性及副作用低。因此,艾灸與藥物結(jié)合治療PSD優(yōu)于單一藥物療法,值得在臨床上更廣泛地應(yīng)用。
[Abstract]:Objective:. Post Stroke depression (PSD), a secondary form of depression, is one of the most common cerebrovascular complications, and the World Health Organization (WHO) notes that. Mental illness is the main disease that human will face in 21th century. Post-apoplectic depression (PSD) includes a variety of mental and physical symptoms of complex emotional disorders. Clinical manifestations of depression, sleep disorders, decreased interest, Prone to fatigue, slow thinking, loss of appetite, pessimism and despair, and even symptoms such as suicide attempts and abnormal behavior. Clinical diagnosis and effective treatment can reduce the rate of disability and mortality of patients. To improve the quality of life. At present, 5-HT reuptake inhibitor (SSRIN) is widely used in the treatment of the disease, but it has the side effects of digestive nerve system, such as nausea, vomiting, dyspepsia, lethargy, sexual dysfunction and so on. And the price is expensive, make the patient difficult to accept, the compliance is poor. And the Chinese medicine has certain superiority to the treatment of this disease and to delay the occurrence and development of the disease. Therefore, the syndromes and the curative effect mechanism of the treatment of post-apoplectic depression by all kinds of traditional Chinese medicine treatment methods are related research. Moxibustion has attracted the attention of scholars both at home and abroad. Moxibustion has a good effect on the disease, no side effects, and the effect is fast. It has been playing an increasingly important role in the treatment of cerebrovascular diseases. Treatment:. Subjects from March 2010 to March 2011 in the Department of Neurology, Jiangsu Provincial Hospital of traditional Chinese Medicine, Nanjing University of traditional Chinese Medicine, met the criteria for the inclusion of post-stroke depression. A total of 60 cases were divided into two groups: treatment group and control group of 30 cases. The treatment group was treated with moxibustion combined with Prozac solution and the control group with Prozac solution. In the treatment group, the moxibustion method was used to treat Xinshu, Ganshu, spleen, Shenshu and Shenshu, and then the Shenque was taken for mild moxibustion to strengthen the function of liver, spleen and kidney. In addition, oral drugs: according to the drug instructions, the maintenance dose of Prozac was given orally for 20 mg / d, and the drug was taken orally in the morning. 15 times a day as a course of treatment, a total of three courses of treatment were performed in the control group. Oral drugs: according to the dosage of drug instructions, the patients were given oral Prozac, 20 mg / d for the first 15 days, then 40 mg / d for the first 15 days. The drugs were taken orally in the morning. 15 times a day for a course of treatment, a total of three courses. Results:. 1. There was no significant difference in general data between the two groups after t test (P 0.05). 2. Hamilton Depression scale (Hamilton Depression scale): the total effective rate of the two groups after treatment was significantly better than that of the control group (73.33%), although there was no significant difference in the total effective rate between the two groups after X2 test, but the total effective rate of the treatment group was 83.3%. 3. Evaluation scale of Acupuncture and moxibustion treatment for Post-apoplectic Depression: after treatment, both groups obtained good curative effect, but the total effective rate of the treatment group was 86.66), which was significantly better than that of the control group (66.67%). The effect of moxibustion combined with Prozac was better than that of Prozac alone. 4. At the end of the treatment, the TESS score of the treatment group was 3.7 鹵1.5g, while the TESS score of the control group was 15.8 鹵4.40.The score was significantly higher than that of the treatment group (P = 0.05). Therefore, it was concluded that moxibustion could control and reduce the side effects of Prozac. Therefore, improve the living conditions of patients. Conclusion:. Moxibustion combined with Prozac and Prozac alone can play a better role in the treatment of PSD. Compared with moxibustion and drug therapy, the curative effect of moxibustion combined with drug therapy on PSD is better than that of moxibustion, and the onset time is short, the duration is low and the side effects are low. Moxibustion combined with drug therapy is better than single drug therapy in treating PSD.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R246.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳力宇,全洪波,王東生,謝瑞滿;百憂解治療中風(fēng)后抑郁的臨床觀察[J];中國醫(yī)師雜志;2003年10期

2 徐文文;馮方俊;;逍遙散加減治療中風(fēng)后抑郁癥的臨床觀察[J];湖北中醫(yī)雜志;2009年10期

3 高紅,陳靜;腦卒中后發(fā)生抑郁的相關(guān)因素[J];黑龍江醫(yī)學(xué);2002年12期

4 張秀榮,趙鴻運(yùn);舒神湯治療中風(fēng)后抑郁癥臨床研究[J];河南中醫(yī);2002年03期

5 唐麗瑩,葉江洪,章亞娟,張優(yōu)琴,聞秀藝;認(rèn)知療法對(duì)腦卒中后抑郁和認(rèn)知障礙的療效觀察[J];解放軍護(hù)理雜志;2002年04期

6 陳景清,張麗,王顯金,欒清明;腦卒中后抑郁[J];健康心理學(xué);1995年01期

7 馬云枝;中西醫(yī)結(jié)合治療腦梗塞后抑郁癥40例臨床觀察[J];北京中醫(yī)藥大學(xué)學(xué)報(bào);2003年02期

8 蘇占清;腦卒中后抑郁障礙[J];臨床精神醫(yī)學(xué)雜志;2000年05期

9 陳心智,王健,王靜慧,臧麗馨;電針健腦安神法治療中風(fēng)后抑郁臨床研究[J];遼寧中醫(yī)雜志;2005年05期

10 丁訓(xùn)艷;;中風(fēng)后抑郁癥的病因及治療[J];遼寧中醫(yī)雜志;2008年08期

，

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