生物波穴位刺激联合中医情志护理对脑卒中后抑郁患者恢复效果的影响

毛亚娣; 孙剑虹; 刘蓝冰; 马兰; 相松飞; 黄春敏; 袁紫刚

doi:10.16766/j.cnki.issn.1674-4152.002924

生物波穴位刺激联合中医情志护理对脑卒中后抑郁患者恢复效果的影响

doi: 10.16766/j.cnki.issn.1674-4152.002924

1.
绍兴市人民医院神经外科，浙江绍兴 312000
2.
绍兴市人民医院泌尿外科
3.
绍兴市人民医院老年病科中西医结合科
4.
绍兴市人民医院康复科
5.
绍兴市人民医院神经内科

基金项目:

浙江省医药卫生科技计划项目 2021KY1153

详细信息

通讯作者:
毛亚娣，E-mail: Maoyadi1005@163.com

中图分类号: R749.13 R248
计量
- 文章访问数: 147
- HTML全文浏览量: 67
- PDF下载量: 6
- 被引次数: 0
出版历程
- 收稿日期: 2022-09-15
- 网络出版日期: 2023-04-19

Effect of bio-wave acupoint stimulation combined with emotional nursing of traditional Chinese medicine on recovery in patients with post-stroke depression

1.
Department of Neurosurgery, Shaoxing people' s Hospital, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的分析生物波穴位刺激联合中医情志护理对脑卒中后抑郁患者抑郁状态、生活质量及康复依从性的影响。方法采用便利抽样法，选取2020年6月—2022年5月绍兴市人民医院收治的120例脑卒中后抑郁(PSD)患者作为研究对象，根据随机数字表法将患者分为对照组(60例)和观察组(60例)。对照组采用常规护理，观察组应用生物波穴位刺激联合中医情志护理。分别于干预前和干预后第1、2、3周运用汉密顿抑郁量表(HAMD)、Barthel指数(MBI)、脑卒中专用生活质量量表(SS-QOL)对2组患者进行评估，并比较2组患者的康复依从性。结果干预后，2组患者HAMD评分均低于干预前，观察组干预后第1、2、3周HAMD评分分别为(22.52±1.87)分、(15.16±2.62)分、(10.24±1.78)分，均低于对照组[(24.16±2.64)分、(19.22±2.97)分、(15.34±2.13)分，均P < 0.05]。2组患者MBI及SS-QOL量表评分均高于干预前，且观察组干预后第1、2、3周MBI及SS-QOL量表评分均高于对照组(均P < 0.05)。观察组康复依从性为96.7%(58/60)，优于对照组的83.3%(50/60)，P < 0.05。结论生物波穴位刺激联合中医情志护理可有效减轻脑卒中后抑郁患者抑郁状态，提高患者日常生活能力、生活质量及康复依从性。
- 生物波穴位刺激 /
- 中医情志护理 /
- 脑卒中后抑郁 /
- 日常生活能力 /
- 生活质量
Abstract: Objective To analyze the effect of bio-wave acupoint stimulation combined with traditional Chinese medicine (TCM) emotional nursing on the depressive status, quality of life and rehabilitation compliance in patients with post-stroke depression. Methods A convenience sampling method was used to select 120 patients with post-stroke depression (PSD) admitted to Shaoxing People' s Hospital from June 2020 to May 2022 as the research objects, and the patients were divided into control group (60 cases) and observation group (60 cases) according to the random number table method. The control group received routine nursing, while the observation group received bio-wave acupoint stimulation combined with TCM emotional nursing. The Hamilton depression scale (HAMD), modified barthel index (MBI), stroke specific quality of life scale (SS-QOL) and rehabilitation compliance scale were used to evaluate the two groups of patients before the intervention and at the first, second and third weeks after the intervention. Results After the intervention, the HAMD scores of patients in both groups were lower than that before intervention, and the HAMD scores in the observation groups were (22.52±1.87) points, (15.16±2.62) points and (10.24±1.78) points at the first, second, and third weeks after intervention, respectively, which were lower than in the control group [(24.16±2.64) points, (19.22±2.97) points, (15.34±2.13) points, all P < 0.05]; The MBI and SS-QOL scores in both groups were higher than those before the intervention, and the MBI and SS-QOL scores in the observation group were higher than those in the control group at the 1st, 2nd and 3rd weeks after the intervention (all P < 0.05); The rehabilitation compliance in the observation group was 96.7% (58/60), which was better than that in the control group [83.3% (50/60), P < 0.05]. Conclusion Bio-wave acupoint stimulation combined with TCM emotional nursing can effectively reduce depression in patients with post-stroke depression, improve their daily life and ability, quality of life and rehabilitation compliance.
- Bio-wave acupoint stimulation /
- Traditional Chinese medicine care /
- Post stroke depression /
- Daily living ability /
- Quality of life

HTML全文

图 1 双侧合谷穴贴敷

Figure 1. Bilateral application of Hegu acupoint

下载: 全尺寸图片幻灯片

图 2 双侧太冲穴贴敷

Figure 2. Bilateral Taichong acupoint application

下载: 全尺寸图片幻灯片

表 1 2组PSD患者干预前后HAMD评分比较(x±s，分)

Table 1. Comparison of HAMD scores before and after intervention in PSD patients in the two groups(x±s, points)

组别	例数	干预前	干预后第1周	干预后第2周	干预后第3周
对照组	60	27.68±2.18	24.16±2.64^a	19.22±2.97^ab	15.34±2.13^abc
观察组	60	28.12±2.53	22.52±1.87^a	15.16±2.62^ab	10.24±1.78^abc
t值		1.021	3.927	7.941	14.232
P值		0.309	< 0.001	< 0.001	< 0.001
注：与同组干预前比较，^aP < 0.05；与同组干预后第1周比较，^bP < 0.05；与同组干预后第2周比较，^cP < 0.05。

下载: 导出CSV

表 2 2组PSD患者干预前后MBI量表评分比较(x±s，分)

Table 2. Comparison of MBI scale scores between the two groups of PSD patients before and after intervention(x±s, points)

组别	例数	干预前	干预后第1周	干预后第2周	干预后第3周
对照组	60	31.19±3.45	38.12±3.25^a	47.81±4.11^ab	60.34±5.56^abc
观察组	60	30.25±3.16	43.63±4.12^a	58.79±5.66^ab	70.56±5.45^abc
t值		1.556	8.133	12.159	10.168
P值		0.122	< 0.001	< 0.001	< 0.001
注：与同组干预前比较，^aP < 0.05；与同组干预后第1周比较，^bP < 0.05；与同组干预后第2周比较，^cP < 0.05。

下载: 导出CSV

表 3 2组PSD患者干预前后SS-QOL量表评分比较(x±s，分)

Table 3. Comparison of SS-QOL scale scores between the two groups of PSD patients before and after intervention(x±s, points)

组别	例数	干预前	干预后第1周	干预后第2周	干预后第3周
对照组	60	121.34±11.28	129.43±9.66^a	134.72±10.86^ab	141.32±11.44^abc
观察组	60	121.77±10.65	134.53±10.76^a	140.73±1.57ab	151.95±12.65^abc
t值		0.215	2.732	4.243	4.828
P值		0.830	0.007	< 0.001	< 0.001
注：与同组干预前比较，^aP < 0.05；与同组干预后第1周比较，^bP < 0.05；与同组干预后第2周比较，^cP < 0.05。

下载: 导出CSV

表 4 2组PSD患者康复依从性比较[例(%)]

Table 4. Comparison of rehabilitation compliance of PSD patients in two groups [cases (%)]

组别	例数	完全依从	部分依从	不依从	康复依从性
对照组	60	29(48.3)	21(35.0)	10(16.7)	50(83.3)
观察组	60	36(60.0)	22(36.7)	2(3.3)	58(96.7)
注：2组康复依从性比较，χ²=5.926，P=0.015。

下载: 导出CSV

参考文献(20)

[1]	DU Y Z, ZHANG L L, LIU W, et al. Effect of acupuncture treatment on post-stroke cognitive impairment: a randomized controlled trial[J]. Medicine (Baltimore), 2020, 99(51): e23803. DOI: 10.1097/MD.0000000000023803.
[2]	HUANG W L, LIAO X Q, TIAN J H, et al. Traditional Chinese medicine for post-stroke depression: a systematic review and network meta-analysis (Protocol)[J]. Medicine (Baltimore), 2018, 97(52): e13840. DOI: 10.1097/MD.0000000000013840.
[3]	LU H, LI M H, ZHANG B, et al. Efficacy and mechanism of acupuncture for ischemic poststroke depression: study protocol for a multicenter single-blinded randomized sham-controlled trial[J]. Medicine (Baltimore), 2019, 98(7): e14479. DOI: 10.1097/MD.0000000000014479.
[4]	CHEN H L, ZHAO M D, LI X M, et al. Comparative effectiveness of different forms of traditional Chinese medicine for treatment of post-stroke depression: protocol for network meta-analysis of randomized controlled trials[J]. Medicine (Baltimore), 2019, 98(30): e16477. DOI: 10.1097/MD.0000000000016477.
[5]	王馨苑, 刘琰, 谭曦. 抑郁症脑成像技术和核脑影像成像技术的研究进展[J]. 中国全科医学, 2021, 24(21): 2701-2706. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202121014.htm WANG X Y, LIU Y, TAN Y. Research progress of brain imaging technology and nuclear brain imaging technology for depression[J]. China General Practice, 2021, 24(21): 2701-2706. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202121014.htm
[6]	李扬, 江华. 心血管代谢性共病与抑郁症的双向关联及对全科实践的意义[J]. 中华全科医师杂志, 2021, 20(11): 1187-1191. LI Y, JIANg H. The two-way association between cardiovascular metabolic comorbidity and depression and its significance for general practice[J]. Chinese Journal of General Practitioners, 2021, 20(11): 1187-1191.
[7]	赵璇, 李晓鹏, 李剑, 等. 磁珠耳穴贴压联合重复经颅磁刺激对脑卒中后抑郁的疗效[J]. 山东大学学报(医学版), 2022, 60(1): 65-70. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYB202201010.htm ZHAO X, LI X P, LI J, et al. Effect of magnetic bead auricular point sticking and repeated transcranial magnetic stimulation on post-stroke depression[J]. Journal of Shandong University (Medical Edition), 2022, 60(1): 65-70. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYB202201010.htm
[8]	金慧英, 翟栋, 金善恩, 等. 耳穴贴压、穴位贴敷、经络艾灸联合情志疗法对乳腺癌根治术患者的效果研究[J]. 中华全科医学, 2019, 17(2): 329-332. doi: 10.16766/j.cnki.issn.1674-4152.000674 JIN H Y, ZHAI D, JIN S E, et al. Clinical effect of auricular pressing therapy, acupoint sticking, meridian moxibustion combined with emotional therapy on patients undergoing radical mastectomy[J]. Chinese Journal of General Practice, 2019, 17(2): 329-332. doi: 10.16766/j.cnki.issn.1674-4152.000674
[9]	王少石, 周新雨, 朱春燕. 卒中后抑郁临床实践的中国专家共识[J]. 中国卒中杂志, 2016, 11(8): 685-693. https://www.cnki.com.cn/Article/CJFDTOTAL-ZUZH201608017.htm WANG S S, ZHOU X Y, ZHU C Y. Chinese expert consensus on clinical practice of post-stroke depression[J]. Chinese Journal of Stroke, 2016, 11(8): 685-693. https://www.cnki.com.cn/Article/CJFDTOTAL-ZUZH201608017.htm
[10]	王纯, 楚艳民, 张亚林, 等. 汉密尔顿焦虑量表的因素结构研究[J]. 临床精神医学杂志, 2011, 21(5): 299-301. https://www.cnki.com.cn/Article/CJFDTOTAL-LCJS201105009.htm WANG C, CHU Y M, ZHANG Y L, et al. Study on the factor structure of Hamilton Anxiety Scale[J]. Journal of Clinical Psychiatry, 2011, 21(5): 299-301. https://www.cnki.com.cn/Article/CJFDTOTAL-LCJS201105009.htm
[11]	黄杨, 施加加, 孙莹, 等. 改良Barthel指数在缺血性脑卒中评估的最小临床重要差值的研究[J]. 中国卫生统计, 2022, 39(2): 215-217, 221. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWT202202012.htm HUANG Y, SHI J J, SUN Y, et al. Study on the minimum clinical significant difference of the modified Barthel index in the evaluation of ischemic stroke[J]. China Health Statistics, 2022, 39(2): 215-217, 221. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWT202202012.htm
[12]	田凤霞. 中文版脑卒中后失语症生活质量量表的信度和效度研究[J]. 护理实践与研究, 2020, 17(4): 10-12. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ202004004.htm TIAN F X. Study on the reliability and validity of the Chinese version of the quality of life scale for aphasia after stroke[J]. Nursing Practice and Research, 2020, 17(4): 10-12. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ202004004.htm
[13]	WANG X F, CAI W, WANG Y P, et al. Is electroacupuncture an effective and safe treatment for poststroke depression? An updated systematic review and meta-analysis[J]. Biomed Res Int, 2021. DOI: 10.1155/2021/8661162.
[14]	YANG J P, ZHAO H, DU Y Z, et al. Study on quantitative diagnosis model of TCM syndromes of post-stroke depression based on combination of disease and syndrome[J]. Medicine (Baltimore), 2021, 100(12): e25041. DOI: 10.1097/MD.0000000000025041.
[15]	李景莉. 穴位按摩联合五行音乐疗法对脑卒中后抑郁伴睡眠障碍患者临床症状和生活质量的影响[J]. 四川中医, 2019, 37(5): 190-192. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY201905067.htm LI J L. Effect of acupoint massage combined with five element music therapy on clinical symptoms and quality of life of patients with post-stroke depression and sleep disorder[J]. Sichuan Traditional Chinese Medicine, 2019, 37(5): 190-192. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY201905067.htm
[16]	杨一帆, 王豆, 李涛, 等. 中医药分期治疗卒中后抑郁研究进展[J]. 陕西中医, 2022, 43(4): 534-537. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZY202204032.htm YANG Y F, WANG D, LI T, et al. Research progress in the treatment of post-stroke depression by stages with traditional Chinese medicine[J]. Shaanxi Journal of Traditional Chinese Medicine, 2022, 43(4): 534-537. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZY202204032.htm
[17]	SU I J, LIAO L L, HUANG F H. A meta-analysis of the effect of abdominal acupuncture on post-stroke depression[J]. Med Acupunct, 2021, 33(4): 269-277.
[18]	邓科军, 夏晗, 王海波, 等. 中药热奄包配合生物电穴位刺激对脑梗死偏瘫患者神经功能及康复效果的影响[J]. 河南中医, 2022, 42(4): 605-609. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZY202204028.htm DENG K J, XIA X, WANG H B, et al. The effect of traditional Chinese medicine "Reyan Bao" combined with bioelectrical acupoint stimulation on neurological function and rehabilitation of patients with cerebral infarction hemiplegia[J]. Henan Traditional Chinese Medicine, 2022, 42(4): 605-609. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZY202204028.htm
[19]	杨亚男, 刘小江. 中医康复治疗联合针灸在中风患者康复中的效果[J]. 吉林中医药, 2021, 41(9): 1244-1247. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJL202109031.htm YANG Y N, LIU X Z. Effect of traditional Chinese medicine rehabilitation treatment combined with acupuncture on the rehabilitation of stroke patients[J]. Jilin Journal of Traditional Chinese Medicine, 2021, 41(9): 1244-1247. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJL202109031.htm
[20]	周元成. 牵正散联合生物电穴位刺激治疗周围性面瘫的临床效果[J]. 广西医学, 2018, 40(21): 2545-2547. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYX201821010.htm ZHOU Y C. Clinical effect of Qianzheng Powder combined with bioelectric acupoint stimulation on peripheral facial paralysis[J]. Guangxi Medical Journal, 2018, 40(21): 2545-2547. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYX201821010.htm