【摘要】：目的:研究耳穴貼壓法聯(lián)合五行音樂療法治療中風(fēng)后抑郁(PSD)的臨床療效,觀察其不良反應(yīng)發(fā)生情況;同時(shí)通過對治療前后血漿同型半胱氨酸(HCY)水平的比較,探討作為炎癥指標(biāo)之一的HCY對PSD的影響。方法:將60例PSD患者,按照隨機(jī)數(shù)字表法隨機(jī)分為2組,治療組采用耳穴貼壓法聯(lián)合五行音樂療法治療,對照組采用常規(guī)的氟西汀口服治療,治療療程共4周。結(jié)果:(1)臨床療效評價(jià):兩組治療后療效均提高,治療組有效率86.67%、對照組有效率83.33%,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。(2)漢密爾頓抑郁量表-17項(xiàng)(HAMD-17項(xiàng))評價(jià):治療組和對照組的HAMD-17項(xiàng)評分在治療后較治療前均有明顯下降,各組組內(nèi)比較差異顯著,有統(tǒng)計(jì)學(xué)意義(P0.05),組間比較無統(tǒng)計(jì)學(xué)差異(P0.05)。(3)日常生活能力(ADL)評價(jià):治療組和對照組的ADL評分在治療后較治療前均有明顯增加,各組組內(nèi)比較差異顯著,有統(tǒng)計(jì)學(xué)意義(P0.05),組間比較無統(tǒng)計(jì)學(xué)差異(P0.05)。(4)神經(jīng)功能缺損評分量表(NIHSS)評價(jià):治療組和對照組的NHISS評分在治療后較治療前均有明顯下降,各組組內(nèi)比較差異顯著,有統(tǒng)計(jì)學(xué)意義(P0.05),組間比較無統(tǒng)計(jì)學(xué)差異(P0.05)。(5)HCY值變化:治療組和對照組的HCY值在治療后較治療前均有明顯下降,各組組內(nèi)比較差異顯著,有統(tǒng)計(jì)學(xué)意義(P0.05),組間比較無統(tǒng)計(jì)學(xué)差異(P0.05)。(6)進(jìn)行安全性分析,具有可行的安全性。治療組不良反應(yīng)發(fā)生率為13.33%,對照組不良反應(yīng)發(fā)生率為30%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:(1)耳穴貼壓法聯(lián)合五行音樂療法能明顯改善PSD患者的臨床癥狀,提高患者生活質(zhì)量,增加其康復(fù)的信心,無明顯不良反應(yīng)。該治療方法療效好,安全性高,具有進(jìn)一步深入研究、開發(fā)應(yīng)用的價(jià)值。(2)HCY水平的降低在一定程度上有益于PSD患者的康復(fù)。
[Abstract]:Objective: to study the clinical effect of auricular acupoint sticking and pressing combined with five elements music therapy in the treatment of post-apoplectic depression (PSD), and to observe the occurrence of adverse reactions. At the same time, by comparing plasma homocysteine (HCY) levels before and after treatment, the effect of HCY, one of the inflammatory markers, on PSD was discussed. Methods: sixty patients with PSD were randomly divided into two groups according to random number table. The treatment group was treated with auricular acupoint pressing combined with five elements music therapy and the control group was treated with routine oral fluoxetine for 4 weeks. Results: (1) Clinical efficacy evaluation: after treatment, the curative effect was improved in both groups, the effective rate in the treatment group was 86.67 and that in the control group was 83.33. There was no significant difference between the two groups (P0.05). (2)-17 items of Hamilton Depression scale (HAMD-17): the scores of HAMD-17 items in the treatment group and the control group were significantly lower than those before treatment, and the difference was significant in each group. There was statistical significance (P0.05). There was no significant difference between the groups (P0.05). (3). (ADL) evaluation of ADL: the ADL scores of the treatment group and the control group were significantly higher than that of the control group after treatment. The differences were significant in each group (P0.05). There was no significant difference between the two groups (P0.05). (4). The NHISS scores of the treatment group and the control group were significantly lower than those of the control group after treatment (P0.05). (4), and there was a significant difference in the NHISS score between the treatment group and the control group. There was statistical significance (P0.05), there was no significant difference between groups (P0.05). (5) HCY value change: the HCY value of treatment group and control group were significantly lower than before treatment, the difference was significant in each group. There was statistical significance (P0.05), there was no statistical difference between the groups (P0.05). (6), the safety analysis was feasible. The incidence of adverse reactions was 13.33 in the treatment group and 30 in the control group (P0.05). Conclusion: (1) Auricular point sticking and pressing combined with five elements music therapy can obviously improve the clinical symptoms, improve the quality of life of the patients with PSD, increase their confidence in rehabilitation, and have no obvious adverse reactions. This method has good curative effect and high safety, and has the value of further research and application. (2) the decrease of HCY level is beneficial to the rehabilitation of PSD patients to some extent.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R255.2

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