【摘要】：目的:觀察火針針刺頭穴及背俞穴治療中風后肝氣郁結型抑郁的臨床療效,為我們臨床治療中風后抑郁提供了更為寬廣的思路和更加有效的治療方法。方法:將臨床中遇到60例中風后抑郁(肝氣郁結型)的患者隨機分為A、B兩組,每組30例,標記A組為治療組(火針組),B組為對照組(毫針組)。在臨床實驗期間,兩組患者均在進行腦血管基礎疾病治療的同時加以火針或毫針治療中風后抑郁。治療組(火針組)取頭穴(神庭、百會、左右雙神聰穴、雙安眠穴)及背俞穴(雙側(cè)心俞、肝俞、脾俞),采用中細(0.5mm×45mm)火針(一般為鎢錳合金制成)在酒精燈上燒至紅透,定準穴位,快速刺入后立即出針。隔日1次,1周3次,治療滿1周為1個療程,共治療3個療程,每個療程結束后休息2d。對照組(毫針組)采用常規(guī)針刺,選穴依據(jù)新世紀(第二版)《針灸治療學》中"郁病"的治療,取神庭、百會、神門、內(nèi)關、合谷、太沖、心俞、肝俞、行間。采用毫針(0.35mmm×40mm)進行針刺,心俞、肝俞采用平刺,行瀉法提插捻轉(zhuǎn),得氣后留針30MIN,每日1次,1周治療滿5次為1個療程,共3個療程,每個療程結束后休息2d。治療開始前和結束時分別對兩組患者抑郁狀況進行評析。采用漢密爾頓抑郁量表(HAMD)24項版本[1]、抑郁自評量表(SDS)[2]中醫(yī)證候抑郁量表[3]進行抑郁狀況評析,應用統(tǒng)計學軟件SPSS19進行所得數(shù)據(jù)的統(tǒng)計學分析。結果:治療組(火針組)與對照組(毫針組)治療前后抑郁程度比較均有顯著差異(P＜0.05);三個療程后,火針組治療PSD總有效率為93.33%,而毫針組總有效率為76.67%,差異有統(tǒng)計學意義(P＜0.05),火針組治療中風后抑郁的臨床療效優(yōu)于毫針組。結論:1、治療組(火針組)與對照組(毫針組)治療中風后抑郁肝氣郁結型均有療效,改善了患者抑郁程度。2、頭穴及背俞穴火針針刺的方法治療中風后抑郁肝氣郁結型的臨床療效更為顯著,也為基礎疾病的治療掃除障礙。
[Abstract]:Objective: to observe the clinical effect of acupoints needling with fire needle and point back-shu on depression of liver qi depression after apoplexy, and to provide us with more broad thinking and more effective treatment method for post-stroke depression. Methods: sixty patients with post-apoplectic depression (liver-qi depression) were randomly divided into two groups: group A (n = 30) and group A (n = 30). During the clinical trial, both groups were treated with fire needle or filiform needle to treat post-stroke depression. In the treatment group (fire acupuncture group), scalp points (Shenting, Baihui, left and right Shencong points, Shuanganmiao points) and backshu points (bilateral Xinshu, Ganshu, Pishu) were taken, and 0.5mm 脳 45mm fire needles (usually made of tungsten and manganese alloy) were used to burn to the red on the wine lamp. Fix the acupoint and give out the needle immediately after the quick puncture. Every other day, 3 times a week, 1 week as a course of treatment, a total of 3 courses of treatment, each course of rest 2 days after the end of the course. The control group (filiform acupuncture group) was treated with routine acupuncture, and acupoints were selected according to the treatment of "depression" in the new century (the second edition) of "acupuncture and moxibustion therapy", which included Shenting, Baihui, Shenmen, Neiguan, Hegu, Taichong, Xinshu, Ganshu, and interline. 0.35mmm 脳 40mm was used for acupuncture, Xinshu and Ganshu were treated with flat needling, the method of purgation and twirling was carried out, and the needle was kept for 30MINM after getting Qi, and 5 times a day for one course of treatment for 3 courses of treatment, with a rest for 2 days after each course of treatment. The depression status of the two groups was evaluated before and at the end of treatment. Hamilton Depression scale (HAMD) was used in 24 items [1], Self-Rating Depression scale (SDS) in TCM Syndrome Depression scale [3] was used to evaluate the depression status, and statistical software SPSS19 was used to analyze the data. Results: there were significant differences in depression between the treatment group (fire acupuncture group) and the control group (millimeter needle group) before and after treatment (P < 0.05). The total effective rate of PSD in the fire acupuncture group was 93.33 and the total effective rate in the filiform needle group was 76.67 (P < 0. 05). The clinical efficacy of the fire acupuncture group was better than that of the filiform needle group in the treatment of post-stroke depression (P < 0. 05). ConclusionThe treatment group (fire acupuncture group) and the control group (Milliform acupuncture group) are effective in the treatment of depression and stagnation of liver-qi after apoplexy. Improved the depressive degree of 0.2, head point and back Shu point fire acupuncture treatment of depression after stroke, the clinical efficacy of liver Qi stagnation more significant, but also for the treatment of basic diseases to remove obstacles.
【學位授予單位】：黑龍江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.6

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