Study On The Mechanism Of "Xingnao Kaiqiao And Jieyu Anshen" Acupuncture Therapy For Post Stroke Depression Based On The Repair Of Inflammatory Injury

Objective:1.To discuss and expound the clinical effect of "Xingnao Kaiqiao and Jieyu Anshen"acupuncture in the treatment of post-stroke Depression.To further determine the effectiveness and safety of the acupuncture method by comparing the effects of acupuncture method and Western medicine on depression,neurological function recovery and activities of daily living.To provide more valuable clinical reference for the treatment of post-stroke depression.2.To observe the level changes of noradrenalin(NE),serum interleukin-1β(IL-1β),serum interleukin-6(IL-6),nuclear factor-κβ(NF-κβ)and Tumor necrosis factor-α(TNF-α)before and after treatment in patients with post-stroke depression.At the same time,we tentatively discuss the mechanism of the onset of acupuncture treatmentMethod:1.General information:We selected 64 cases of post-stroke depression from February 2017 to February 2018 in the Department of brain diseases of the People’s Hospital of Fujian Province.The random number table was used to divide into the acupuncture group and the control group,32 cases in each group.2.Treatment methods:All patients received stroke routine western medicine according to the clinical condition.On this basis,the control group was given fluoxertine hydrochloride.Acupuncture group was treated with u Xingnao Kaiqiao and Jieyu Anshen "acupuncture treatment on the basis of the control group.Two groups of patients treatment are for 1 month.3.Main Outcome Measures:The HAMD scale score,the NIHSS scale score,and the ADL scale score were assessed at the beginning of the treatment and tAventy-eighth days of treatment.The effect of acupuncture on post-stroke depression was observed and determined according to the reduction of total score of HAMD before and after treatment.The recovery of neurological deficits and activities of daily living was evaluated by NIHSS and ADL scale scores in patients with PSD.At the same time,the serum levels of NE,NF-κβ,IL-1β,IL-6 and TNF-a were monitored in both groups of patients.In order to explore the onset mechanism of acupuncture treatment,the test results were combined with changes in scores of the HAMD.Finally,assess the safety of acupuncture therapy according to clinical adverse reaction monitoring and assessment.Results:1.The data of the 60 patients who completed the experiment before the treatment,such as age,sex,education level,etc.,showed no statistical difference by chi-square test and homogeneity test of variance(P>0.05).2.There was no significant difference in HAMD,NIHSS,and ADL scores between the two groups before the treatment of the disease(P>0.05),indicating that they were comparable.After 4 weeks of treatment,the HAMD and NIHSS of both groups decreased,and the ADL scores improved.The intragroup comparison was statistically significant(P<0.01).The efficacy of the acupuncture group was most prominent.3.After treatment,the levels of NF-κβ,IL-1β,IL-6 and TNF-α decreased,and the NE content increased.The difference was statistically significant before and after treatment(P<0.05).And there was a correlation between the changes of NE,NF-κβ,IL-1β,IL-6,TNF-α and HAMD scale.The acupuncture group had better efficacy than the control group.4.The total effective rate in the acupuncture group was 86.67%,and the total effective rate in the control group was 66.67%.After statistical analysis,the total effective rate difference between the two groups was statistically significant(P<0.05).5.The acupuncture group show less side effects in the treatment of post-stroke depression,and don’t affect continued treatment,and no life-threatening symptoms.Conclusion:1.The acupuncture of "Xingnao Kaiqiao and Jieyu Anshen" can effectively improve the patient’s depression,neurological deficits,activities of daily living and disease prognosis,which is safe without side effects.The use of acupuncture for the treatment of depression after stroke is more effective than western medicine,which provides a strong basis for acupuncture treatment of diseases of the nervous system.2.The degree of depression in patients with PSD was positively correlated with IL-1β,IL-6,TNF-α,NF-κβ,and negatively correlated with NE content.The higher the degree of depression in patients,the higher the levels of IL-1β,IL-6,TNF-α and NF-κβ and the lower the NE content.3.Acupuncture treatment of PSD may inhibit the expression of NF-κβ protein and reduce the levels of inflammatory factors such as IL-1β,IL-6,TNF-α,etc.,and promote the release of neurotransmitters such as NE.It also alleviates the expression of inflammatory factors,reduces the degree of inflammation,and exerts anti-inflammatory effects,thereby improving depression in PSD patients.This provides a new model of acupuncture and action mechanism for the clinical treatment of PSD.