Abstract:

Objective　To observe the effect of long-term reverse moxibustion on preventing post-stroke depression in patients with acute cerebral infarction. Methods　This study was a randomized controlled trial. Eighty patients with acute cerebral infarction admitted to Haibin Sanatorium of Jiangsu Province and Lianyungang Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were prospectively selected as the study objects, and were divided into a treatment group (40 cases) and a control group (40 cases) according to the random number table method. In the treatment group, there were 21 males and 19 females, aged (64.55±9.37) years. In the control group, there were 22 males and 18 females, aged (64.58±8.89) years. The control group received standardized treatment for stroke, including anti-platelet aggregation, lipid reduction, and symptomatic treatment for patients with hypertension, diabetes, and coronary heart disease. The treatment group was treated with long-term reverse moxibustion on the basis of the control group, 20 min/time, once a day, 5 days/week, lasting for 24 weeks. The scores of Hamilton Depression Scale (HAMD), Mini-Mental State Examination (MMSE), Barthel index (BI), and National Institutes of Health Stroke Scale (NIHSS) and the incidence of post-stroke depression were compared between the two groups before treatment and after 4, 8, 12, and 24 weeks of treatment. Independent sample t test and χ² test were used. Results　The incidences of post-stroke depression in the treatment group after 4, 8, 12, and 24 weeks of treatment were lower than those in the control group [2.5% (1/40) vs. 17.5% (7/40), 5.0% (2/40) vs. 20.0% (8/40), 10.0% (4/40) vs. 27.5% (11/40), 17.5% (7/40) vs. 37.5% (15/40)], with statistically significant differences (χ²=5.000, 4.114, 4.021, and 4.013; all P<0.05). The HAMD scores of the treatment group after 4, 8, and 12 weeks of treatment were lower than those of the control group [(7.25±2.88) points vs. (9.07±4.21) points, (9.70±2.74) points vs. (11.28±3.58) points, (12.17±2.76) points vs. (13.85±3.54) points], with statistically significant differences (t=2.261, 2.210, and 2.358; all P<0.05). The MMSE scores of the treatment group after 12 and 24 weeks of treatment were higher than those of the control group [(23.60±1.89) points vs. (22.70±1.83) points, (24.93±1.46) points vs. (23.75±1.63) points], with statistically significant differences (t=2.163 and 3.400, both P<0.05). The BI scores of the treatment group after 4, 8, 12, and 24 weeks of treatment were higher than those of the control group [(66.13±6.84) points vs. (62.88±10.35) points, (69.25±4.88) points vs. (65.75±5.26) points, (73.13±4.63) points vs. (70.38±4.58) points, (74.63±3.47) points vs. (71.75±4.46) points], with statistically significant differences (t=2.091, 3.087, 2.671, and 3.216; all P<0.05). After treatment, the NIHSS score of the treatment group was lower than that of the control group [(7.20±2.43) points vs. (11.03±2.70) points], with a statistically significant difference (t=6.655, P<0.05). Conclusion　Long-term reverse moxibustion at Baihui and Dazhui points in patients with acute cerebral infarction can promote the recovery of neurological function, improve the cognitive function, and reduce the incidence of post-stroke depression.

Key words:

Post-stroke depression, Cerebral infarction, Reverse moxibustion, Long course of treatment, Prevention

摘要：

目的　观察长疗程逆灸对急性脑梗死患者预防卒中后抑郁发生的效果。方法　本研究为随机对照试验，前瞻性选取2021年1月至2022年12月江苏省海滨康复医院及连云港市中医院收治的80例急性脑梗死患者为研究对象，按照随机数字表法分为治疗组（40例）及对照组（40例）。治疗组男21例、女19例，年龄（64.55±9.37）岁；对照组男22例、女18例，年龄（64.58±8.89）岁。对照组给予卒中规范化治疗，主要包括抗血小板聚集，降脂，合并有高血压、糖尿病以及冠心病患者均给予相应对症治疗；治疗组在对照组基础上采用长疗程逆灸治疗，20 min/次，1次/d，5 d/周，持续24周。对比两组患者治疗前及治疗4周、8周、12周、24周的汉密尔顿抑郁量表（HAMD）、简易智力状态检查量表（MMSE）、Barthel指数（BI）、美国国立卫生研究院卒中量表（NIHSS）评分及卒中后抑郁发生率。采用独立样本t检验、χ²检验。结果　治疗组患者治疗4周、8周、12周、24周卒中后抑郁发生率均低于对照组［2.5%（1/40）比17.5%（7/40）、5.0%（2/40）比20.0%（8/40）、10.0%（4/40）比27.5%（11/40）、17.5%（7/40）比37.5%（15/40）］，差异均有统计学意义（χ²=5.000、4.114、4.021、4.013，均P<0.05）。治疗组治疗4周、8周、12周HAMD评分均低于对照组［（7.25±2.88）分比（9.07±4.21）分、（9.70±2.74）分比（11.28±3.58）分、（12.17±2.76）分比（13.85±3.54）分］，差异均有统计学意义（t=2.261、2.210、2.358，均P<0.05）。治疗组治疗12周、24周MMSE评分均高于对照组［（23.60±1.89）分比（22.70±1.83）分、（24.93±1.46）分比（23.75±1.63）分］，差异均有统计学意义（t=2.163、3.400，均P<0.05）。治疗组治疗4周、8周、12周、24周BI评分均高于对照组［（66.13±6.84）分比（62.88±10.35）分、（69.25±4.88）分比（65.75±5.26）分、（73.13±4.63）分比（70.38±4.58）分、（74.63±3.47）分比（71.75±4.46）分］，差异均有统计学意义（t=2.091、3.087、2.671、3.216，均P<0.05）。治疗后，治疗组NIHSS评分低于对照组［（7.20±2.43）分比（11.03±2.70）分］，差异有统计学意义（t=6.655，P<0.05）。结论　长疗程逆灸急性脑梗死患者百会、大椎穴，可促进脑梗死患者神经功能恢复，改善认知功能，降低卒中后抑郁发生率。

关键词:

卒中后抑郁, 脑梗死, 逆灸, 长疗程, 预防