Dissertation > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke)

Clinical study on the treatment of post stroke depression by regulating the liver and invigorating spleen, phlegm resolving and collateral unblocking acupuncture and medicine

Author JinXiuLin
Tutor ChenZhiGang
School Beijing University of Traditional Chinese Medicine
Course Chinese medical science
Keywords post stroke depression acupuncture and medicine regulating theliver and invigorating spleen resolving phlegm and dredging collaterals
CLC R743.3
Type PhD thesis
Year 2014
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Post stroke depression (post-stroke depression, PSD) is a common complica-tion of stroke and stroke were the main cause of Dutch act, seriously affecting the quality of life of patients and their family members. Because there is no specific symptoms, there is no biological indicatorsspecific, and some patients with language disorder or mental retardation,not depressive symp-toms were detected, easily missed diagnosis. Therefore, early detection of depression after stroke can significantly improve the prognosis and quality of life in patients with stroke and early treatment.At present, the antidepressant treatment problems of slow, long course of treatment, side effects, poor patient compliance, high cost, serious impact on the treatment compliance. Chinese medicine treatment has obvious advantages in the treatment of this disease and delay theoccurrence and development of disease, so an effective Chinese medicine treatment method has important meaning.In this study, through literature, with ten Chinese medicine symptom frequency distribution induces the post-stroke depression in patients withthe most common:depression, reduce interest, whole body fatigue, sleep disorders, irritability, dizziness, loss of appetite, Yaoxisuanruan, aversion to cold, clear urine long, according to its symptom free, light in weight,, to varying degrees, respectively, given the corresponding score, TCMsymptom score scale for depression after stroke. At the same time scalefrom the aspects of depress-ion, sleep, nervous function defect,comprehensive study of Chinese medicine treatment of depression after stroke clinical efficacy and safety evaluation.[Objective] the quantity of TCM symptoms scale and depression, sleep, nervous function defect of the scale, the curative effect of comprehensive study of Chinese medicine in the treatment of post-stroke depression.[Methods] according to random number table, during the period from2012September to2014January American stroke in Losangeles area Eastern Medicine clinic and Beijing University of Chinese Medicine EastHospital of depressed patients were randomly divided into treatment group and control group, each group30patients. The two groups were given the cerebrovascular disease prevention and treatment and twograde according to the antidepressant treat-ment under the guidance of the physician’s condition, the patients in the treatment group weretransferred to the liver Fupi, Huatan Tongluo method, using acupunctureplus traditional Chinese medicine treatment, the treatment period of8weeks. The Rankin scale compared2groups of patients, treatment for2 weeks,4weeks,8weeks of TCM symptoms scale, Hamilton depression scale, America NIH stroke scale, daily life ability scale, Pittsburgh sleep quality index (mRS) score, modified, combined with relevant content at different time scale study on the correlation between the scores of scorechanges and scale, multi level to discuss the curative effect of Chinese medicine in the treatment of depression after stroke, to provide new ideas for the Chinese medicine treatment of depression after stroke.[Result]1. general informationIn60patients, male cases accounted for45%;33cases of womenaccounted for55%, female morbidity than men; smokers accounted for48.3%; alcohol accounted for33.3%; high incidence of essential hypertension, and dyslipidemia and diabetes.Patient age, sex, education, smoking and drinking history and past history of the chi square test showed no significant difference (P>0.05),with compar able.2. the evaluation scale and Hamilton Depression Scale (HAMD) correlationThe2groups at different time points of symptoms scale, NIHSS scale, ADL score, MRS score and the Pittsburgh sleep quality index(PSQI) score for rank correlation test and HAMD scale, the results suggest that the2group of TCM symptoms score and HAMD scorecorrelated (P<0.05); the control group of4point HAMD the scores andNIHSS scores correlated (P<0.05); control group with the correlation between the4point HAMD score and ADL score (P<0.05); the control group before and after treatment, HAMD score and MRS scorecorrelated (P<0.05).3. there is a correlation between the group PSQI score and HAMD score (P<0.05).The result indicates that on the one hand symptoms scale and Pittsburgh Sleep Questionnaire and HAMD scale consistency evaluation from the depression symptoms, causes us to multi angle of acupuncture and medicine treatment efficiency, at the same time reminds us of post stroke depression degree and God withthe function damage degree, patients daily living ability and prognosis, causing symptoms of depression in our early active intervention after stroke, so as to strengthen the rehabilitation of extremities function.Were assessed from the aspects of depression, sleep, neural function defect, comprehensive study of regulating liver Fupi, phlegm resolving and collateral unblocking acupuncture and medicine efficacy of thetreatment of post stroke depression. The results showed that the treatment group before and after treatment of TCM symptom score, HAMD score, NIHSS score, ADL score, Pittsburgh sleep quality indexscore was statistically significant (P<0.05), and the treatment of8weeksand2weeks groups, Wednesday the4point score, there was significant difference between the treatment group and there was significant difference; the control group treatment of MRS (P<0.05). Promptregulating liver Fupi, phlegm resolving and collateral unblockingacupuncture and medicine from the improvement of depressive symptoms, sleep quality, neural function defect, improve the quality of life of patients and the prognosis has played a certain effect.4. laboratory examinationThe treatment group and the control group before and after treatment, total cholesterol, triglyceride levels decreased, there was significant difference (P<0.05); the control group before and after treatment and8weeks of treatment and treatment group and high density lipoproteinwere statistically significant difference (P<0.05); the treatment group and the control group before and after treatment in low density lipoproteindecreased, there was significant difference (P<0.05); the2groups were enrolled and treatment of blood glucose level in fasting for8weeks nodifferences (P>0.05). On one hand consider lipid situation has improvedby two grade prevention in patients with cerebrovascular disease, was also proved that the spleen, regulating the liver Fu Huatan Tongluodrugs and acupuncture treatment with no negative effects on blood lipid and blood glucose.5. the adverse reactionSummary of acupuncture and Chinese medicine in treating common adverse reactions:gastrointestinal symptoms, skin allergies, sore throat,dizziness, headache, palpitation and chest tightness, regulating the liver and spleen were observed to help, phlegm resolving and collateral unblockingacupuncture and Chinese medicine treatment of post-stroke depression is a small number of patients with adverse reactions, but the symptom is light, does not affect the continuation of treatment, and did not appear life-threatening symptoms. No difference between2groups (P>0.05).6. drug addition and subtraction situationCompared before and after treatment in patients with drug (the number of dosage and medication) addition and subtraction, chi square testsuggest that the2have difference (P<0.05).[Conclusion] 1. There is a correlation between the post stroke depression andneurological deficits, patients daily living ability and prognosis, TCM symptom scale and Pittsburgh sleep quality index can be from depression common associated symptoms and sleep assessment ofpatients with depressive symptoms, and HAMD scale evaluationassociation.2. regulating the liver and invigorating spleen, phlegm resolving and collateral unblocking acupuncture can improve the patient’s depressive symptoms, sleep quality, neural function defect, quality of life of patientsand the prognosis, clinical safety and effectiveness.

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