本文關(guān)鍵詞：不同頻率頭電針聯(lián)合經(jīng)顱直流電刺激治療卒中后抑郁的療效觀(guān)察　出處：《湖北中醫(yī)藥大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 不同頻率 頭電針 經(jīng)顱直流電刺激 卒中后抑郁 療效觀(guān)察

【摘要】：目的:以腦卒中后抑郁患者為臨床研究對(duì)象,在常規(guī)康復(fù)治療的基礎(chǔ)上,比較不同頻率頭電針聯(lián)合經(jīng)顱直流電刺激治療腦卒中后抑郁的療效,同時(shí)對(duì)兩者的安全性進(jìn)行評(píng)價(jià),為優(yōu)化頭電針治療腦卒中后抑郁的電針頻率選擇提供依據(jù)。方法:采用隨機(jī)數(shù)字表法將符合納入標(biāo)準(zhǔn)的受試者分配至低頻頭電針聯(lián)合經(jīng)顱直流電刺激治療組(2Hz+tDCS組,20例)、高頻頭電針聯(lián)合經(jīng)顱直流電刺激治療組(50Hz+tDCS組,19例)。選取頂中線(xiàn)、額中線(xiàn)以及雙側(cè)頂顳后斜線(xiàn)進(jìn)行頭針刺。其中頂中線(xiàn)、一側(cè)頂顳后斜線(xiàn)為一組;額中線(xiàn)、一側(cè)頂顳后斜線(xiàn)為一組,兩組頭穴線(xiàn)交替接電針。每日一次,每次治療30分鐘,每周治療六次,連續(xù)治療4周。頭電針治療后間隔30分鐘再進(jìn)行經(jīng)顱直流電刺激治療。參照國(guó)際10-20腦電圖系統(tǒng),將大小為5x5cm2的等滲鹽水明膠海綿電極的陽(yáng)、陰極置于左、右側(cè)背外側(cè)前額葉頭皮區(qū)。電流強(qiáng)度2mA,每日一次,每次20min,每周治療六次,連續(xù)治療4周。觀(guān)察漢密爾頓抑郁量表評(píng)分、日常生活活動(dòng)能力評(píng)分及血漿同型半胱氨酸水平的變化,進(jìn)行統(tǒng)計(jì)分析,并比較療效差異。結(jié)果:1.與治療前評(píng)分相比,治療結(jié)束后兩組患者的漢密爾頓抑郁量表評(píng)分均顯著下降,且低頻頭電針組評(píng)分下降幅度要高于高頻頭電針組,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。2.與治療前基線(xiàn)水平相比,治療結(jié)束后兩組患者的Barthel指數(shù)評(píng)分均上升,且低頻頭電針組評(píng)分上升幅度要高于高頻頭電針組,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。3.與治療前相比,治療結(jié)束后兩組患者的血漿同型半胱氨酸水平均下降,且低頻頭電針組同型半胱氨酸水平下降幅度要高于高頻頭電針組,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。4.治療結(jié)束后,低頻頭電針組的顯效率要高于高頻頭電組,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。低頻頭電針組的總有效率高于高頻頭電針組,但差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論:本臨床試驗(yàn)表明,頭電針聯(lián)合經(jīng)顱直流電刺激能改善卒中后抑郁患者的HAMD、ADL評(píng)分,降低血漿同型半胱氨酸水平。低頻頭電針治療更能顯著改善卒中后抑郁癥狀,且顯效率要高于高頻頭電針治療。
[Abstract]:Objective: to patients with depression after stroke clinical research object, on the basis of routine rehabilitation therapy, clinical therapeutic effect comparison of different frequency of head acupuncture combined with transcranial direct current stimulation after stroke, and evaluate the safety of the two, provide the basis for the optimization of head acupuncture in the treatment of post stroke depression selection frequency of electroacupuncture methods: using the method of random number table will meet the inclusion criteria of the subjects were assigned to the low frequency of head acupuncture combined with transcranial electric stimulation treatment group (20 cases of group 2Hz+tDCS), high-frequency electroacupuncture combined with transcranial direct current stimulation treatment group (19 cases in group 50Hz+tDCS). Select the top line, and bilateral parietal and frontal midline the temporal head acupuncture. Slash after the top line, side D as a group; frontal midline, side D as a group, two groups of scalp electroacupuncture. The alternate line once a day, 30 minutes each treatment, treatment six times a week First, for 4 consecutive weeks. After the treatment interval of 30 minutes and then transcranial direct current stimulation treatment. According to the international 10-20 EEG system, the size of 5x5cm2, the isotonic saline gelatin sponge electrode Yang, the cathode was placed in the left, right dorsolateral prefrontal scalp area. The current intensity of 2mA, once daily, 20min each time. Treatment six times a week for 4 consecutive weeks. Observe the Hamilton depression scale, changes in activities of daily living score and plasma homocysteine levels, statistical analysis, and compare the differences in efficacy. Results: 1. score compared with before treatment, after treatment two groups of patients with Hamilton Depression Scale scores were significantly decreased and low frequency electro acupuncture group, head score decreased thanthat of high-frequency electro acupuncture group, the difference was statistically significant (P0.05) compared with.2. before treatment at baseline and end of treatment Barthel index of the two groups of patients after scoring All rise, and low head acupuncture group score increased more than high-frequency electro acupuncture group, the difference was statistically significant (P0.05.3.) compared with before treatment, two groups of patients after treatment of plasma homocysteine levels were decreased, and the low frequency electroacupuncture group head of homocysteine level decreased thanthat of LNB EA group, have statistically significant differences (P0.05) after.4. treatment, low head EA group the effective rate is higher than that of high-frequency electric group, the difference was statistically significant (P0.05). The low head acupuncture group the total efficiency is higher than that of high-frequency electro acupuncture group, but the difference was not statistically significant (P0.05). Conclusion: the clinical trial of electroacupuncture combined with head transcranial direct current stimulation can improve HAMD patients with depression after stroke ADL score, decreased the plasma homocysteine level. The low head acupuncture treatment can improve the symptoms of depression after stroke, and significantly higher efficiency than High frequency electro acupuncture therapy.

【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R246.6

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