Clinical Observation On 60 Cases Of Aphasic Post-stroke Depression And The Changed Levels Of COR?sAA Treated By Tiaoshen Kaiqiao Acupuncture

Objectives:Post stroke depression(PSD)is a kind of dysfunction after stroke,which is mainly caused by central damage.Patients suffer from loss of pleasure,depression and aphasia,while severe patients often have suicidal tendency,which not only aggravates the cognitive disorder after stroke,hinders the recovery process,but also increases the morbidity rate,mortality rate and recurrence rate.To evaluate the effectiveness and safety of "Tiaoshen Kaiqiao" acupuncture on patients with aphasic PSD,and changed levels of salivary cortisol(COR)and salivary AlphaAmylase(s AA),to further explore its biological mechanism.In order to provide preexperimental data for the follow-up large-scale,multi-center randomized controlled trials,and make efforts on the treatment of aphasic PSD.Methods:From September 2019 to January 2020,60 patients coming from the acupuncture department and outpatient department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine with aphasic PSD were randomly divided into treatment group and control group.Both two groups were given common drugs for the treatment of post-stroke aphasia.On the basis,the experimental group was given "Tiaoshen Kaiqiao" acupuncture method,and the control group was given sham acupuncture therapy.The treatment cycle was 4 weeks,the frequency was 6 times / week,leaving the needle for 30 min.The patients were evaluated clinically by the fixed person independently before treatment and after 4 weeks of treatment.The observation indicators adopted the curative effect index: Stroke Aphasic Depression Questionnaire-Hospital Version(SADQ-H);Laboratory index: salivary COR,s AA,with Enzyme-Linked Immunosorbent Assay(ELISA)protein detection technology carrying out,and the results were statistically analyzed to evaluate the effect and safety of "Tiaoshen Kaiqiao" acupuncture method on aphasic PSD,and verify its biological mechanism.Results:A total of 60 cases were included,1 case was shedding,and 59 cases were finally completed.1 General informationBoth gender,age,height,weight,education background,profession,disease duration,TCM syndrome type,complication,combined medicine,the difference between the groups was not statistically significant(P>0.05),comparable.2 Qualitative index2.1 Baseline indexBoth SADQ-H scale,salivary COR and s AA concentration,the difference between the groups was not statistically significant(P>0.05),comparable.2.2 Curative effect index(1)Evaluation of SADQ-H Scale: The comparison of the experimental group and the control group were both effective in the aphasic PSD patients inner groups(P<0.01,P<0.05).There was significant difference between the two groups(P<0.01).(2)Efficacy evaluation: after 4 weeks of treatment,the difference between the experimental group and the control group was statistically significant(P<0.01)2.3 Laboratory index(1)Level of salivary COR: The level of salivary COR in both experimental group and control group were lower than those before treatment(P < 0.01).There was a significant difference between the two groups(P<0.05).(2)Level of s AA: The level of s AA in experimental group was lower than those before treatment(P<0.01),while it showed no difference in the control group(P>0.05).There was a significant difference between the two groups(P<0.05).Conclusion:1.The acupuncture method of "Tiaoshen Kaiqiao" may have an effect on the depression symptom of aphasic PSD patients;2.By reducing the secretion of salivary COR and s AA,"Tiaoshen Kaiqiao" acupuncture may regulate the Hypothalamic Pituitary Adrenal(HPA)axis and sympatheticoadrenomedullary(SAM)axis,and improve the depression symptom of aphasic PSD patients.