不同频率头电针联合经颅直流电刺激治疗卒中后抑郁的疗效观察

发布时间：2018-01-05 05:30

本文关键词：不同频率头电针联合经颅直流电刺激治疗卒中后抑郁的疗效观察　出处：《湖北中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:以脑卒中后抑郁患者为临床研究对象,在常规康复治疗的基础上,比较不同频率头电针联合经颅直流电刺激治疗脑卒中后抑郁的疗效,同时对两者的安全性进行评价,为优化头电针治疗脑卒中后抑郁的电针频率选择提供依据。方法:采用随机数字表法将符合纳入标准的受试者分配至低频头电针联合经颅直流电刺激治疗组(2Hz+tDCS组,20例)、高频头电针联合经颅直流电刺激治疗组(50Hz+tDCS组,19例)。选取顶中线、额中线以及双侧顶颞后斜线进行头针刺。其中顶中线、一侧顶颞后斜线为一组;额中线、一侧顶颞后斜线为一组,两组头穴线交替接电针。每日一次,每次治疗30分钟,每周治疗六次,连续治疗4周。头电针治疗后间隔30分钟再进行经颅直流电刺激治疗。参照国际10-20脑电图系统,将大小为5x5cm2的等渗盐水明胶海绵电极的阳、阴极置于左、右侧背外侧前额叶头皮区。电流强度2mA,每日一次,每次20min,每周治疗六次,连续治疗4周。观察汉密尔顿抑郁量表评分、日常生活活动能力评分及血浆同型半胱氨酸水平的变化,进行统计分析,并比较疗效差异。结果:1.与治疗前评分相比,治疗结束后两组患者的汉密尔顿抑郁量表评分均显著下降,且低频头电针组评分下降幅度要高于高频头电针组,差异有统计学意义(p0.05)。2.与治疗前基线水平相比,治疗结束后两组患者的Barthel指数评分均上升,且低频头电针组评分上升幅度要高于高频头电针组,差异有统计学意义(p0.05)。3.与治疗前相比,治疗结束后两组患者的血浆同型半胱氨酸水平均下降,且低频头电针组同型半胱氨酸水平下降幅度要高于高频头电针组,差异有统计学意义(p0.05)。4.治疗结束后,低频头电针组的显效率要高于高频头电组,差异有统计学意义(p0.05)。低频头电针组的总有效率高于高频头电针组,但差异无统计学意义(p0.05)。结论:本临床试验表明,头电针联合经颅直流电刺激能改善卒中后抑郁患者的HAMD、ADL评分,降低血浆同型半胱氨酸水平。低频头电针治疗更能显著改善卒中后抑郁症状,且显效率要高于高频头电针治疗。
[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.

【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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