Clinical Study On Post Stroke Depression Treated With Acupuncture Combined With Fluoxetine

Purpose:Post stroke depression is a kind of disease including many mental symptoms and physical symptoms,it's a complicated affective disorders,witch caused by stoke.Stroke has the highest mortality rate of human.Two thirds of stroke patients complicated with depression in 2 years.The affective disorders shows:the patient is lack of interest to everything,emptiness,boredom,apathy,world -weariness,and so on.the attack of depression affect the quality of patient' s life and the healing of neurological deficits,It' s also cause higher death rate than common stroke patients.So lots of doctor think much of it as a therapeutics unit.At present,we often cure it by antidepressant drugs,but it has many shortage such as:much side effects,contraindications,witch cause unnecessary pains to the patient,it's high price also restricts the clinic using of the untidepressant drugs.The acupuncture treatment has many vantages like:affordable,rapid effect,non side-effect,it develops more superiorities in the treatment of stroke disease.Methods:The 40 cases selected are inpatients or outpatients of acupuncture office of Hubei TCM Hospital came during August,2007 to January,2009,who' re diagnosed as Ischemic Apoplexy by Brain CT,and accord with the diagnose standard established by the 4 national vascular disease conference,and the HAMO mark≥18.and accord with Apoplexy Diagnose and Efficacy Standard of TOM diagnose standard,To separate the 40 cases randomly into two groups:the treatment group(the treatment group) has 20 cases,including 11 males and 9 females,whose average age is 61.5±6.34,the average HAMD mark is 34.07±4.39;the comparative group has 20 cases, including 10 males and 10 females,whose average age is 60.4±9.13, the average HAMD mark is 32.12±4.28.The treatment group use acupuncture and drugs,the comparative group use drugs,the acupuncture treatment choose baihui,sishencong, xinshu(double),shenshu,shenmen,neiguan,choose the following points by the various symptoms:qimen,fenglong,sanyinjiao,geshu,To penetrate Baihui,sishencong into back head,ended as the patients feel acerbic and distensible to radiate to the back;stick into the other points,until the patients feel acerbic and distensible,To move about the needles every 10 minutes,twisting left-and-right at xinshu,shenshu,shenmen,neiguan,shenmen,qimen, geshu,zusanli,equal technique at taichong,twisting right-and-left at fenglong.remain for 30 minutes.Treat once a day.take Fluosefine hydrochloride orally,the patient of treatment group takes 20mg/d,the comparative takes 20mg/d in the early 14 days,then take 40mg/d,take the drugs at morning,none use other untidepressant drugs,antipsychotic drugs or calmative.Evalution method:Grade the patients at the 7,14,28,42d using Hamilton depression scale,judge the effect with the mark reducing rate.clinic control: HAMD reducing rate≥75%;effectual:≥50%and＜75%;improvement: ≥25%and＜50%;no effect:＜25%.Establish PSD clinical treatment scale(PSDS),grade the patients at 7,14,28,42d.Marked as:none:0 point;slight:1 point;moderate:2 point; serious:3 point;mark the chief symptoms as:none:0 point;slight:2 point;moderate:4 point;serious:6 point,account the symptoms grade,clinic control:reducing rate≥80%;effectual:reducing rate≥50%and＜80%;improvement:reducing rate≥25%and＜50%; no effect:reducing rate＜30%.The side-effect evaluation:Grade the patients at the 7,14,28,42d using Treatment Emergent Symptom Scale(TESS),After the treatment,evaluate the tolerance dgree:the tolerance is up to the hammer with no side-effect;the tolerance is all right with little side-effect,and affect the patient slightly;the tolerance is non-ideal,and affect patient seriously;intolerabily,the side-effect is superior the effect.The two groups are compared by t-test,P＞0.05,showing no significant difference,so demonstrates they are comparable.Results:1 The two groups are compared by t-test,P＞0.05,showing no significant difference,so demonstrates they are comparable.2 Clinical curative effects show that the remarkable effective rate of the treatment group is 70.0%as well as the effective rate is 85%,and the remarkable effective rate of the control group is 50%as well as the effective rate is 70%,of which are compared by x~2-test and t-test,P＜0.05, showing they have significant difference on curative effect,so demonstrates the curative effect of the treatment group is superior to the control group.3 the two groups results on the 14d shows:the treatment group HAMD mark reducing significantly and the reducing rate is increasingly,the treatment group' s mark reducing rate is more than 35%,the comparative group HAMD and PSDS mark' s reducing speed is slower than the treatment,the treatment group start effect time is early the the comparative group.4 TESS side-effect evaluation results:finish the 42d' s treatment,the treatment group TESS average mark is 3.6±1.5,the comparative TESS average mark is 13.7±3.8,higher the the treatment obviously(P＜0.01).and with the treatment gose on,the treatment group' s side-effects are decreased without specially treatment. The symptoms like mouth dryness,constipation of the comparative group are not alleviated evidently,The compliableness of the treatment group is better than the comparative group.Conclusion:Both acupuncture and drug treatment and drugs treatment are able to play specific effects,compared the two methods,combine acupuncture with drugs can shorten the start effect time,easy to operate,lessen the side-effect,the most important is the effect is better.So combine acupuncture and drug treatment is superior the only using drug,it' sworth to spread to clinical application.