针刺治疗卒中后抑郁的研究概述
Review of Acupuncture Treatment for Post-Stroke Depression
DOI: 10.12677/acm.2025.1592607, PDF,   
作者: 王 莹：黑龙江中医药大学研究生院，黑龙江 哈尔滨；张 淼*：黑龙江中医药大学附属第二医院针灸十科，黑龙江 哈尔滨
关键词: 卒中后抑郁；针刺疗法；作用机制；综述；Post-Stroke Depression； Acupuncture Therapy； Mechanism of Action； Review
摘要: 卒中后抑郁是脑血管疾病后最常见且危害严重的并发症之一，显著降低患者生存质量与功能预后。针刺作为中医药特色技术，凭借整体调衡、靶点丰富、副作用小等优势，日益成为本病综合干预的重要手段。本文系统检索近年国内外数据库，从单胺递质–受体系统、神经营养因子、炎症免疫、脑肠菌群轴、HPA轴及脑网络重塑六个维度梳理针刺的作用机制，并依次列举电针、头针、腹针、火针及联合方案的研究现状与操作要点，以期为后续临床路径优化与循证实践提供参考。
Abstract: Post-Stroke Depression stands as one of the most prevalent and severe complications following cerebrovascular diseases, significantly compromising patients’ quality of life and functional recovery. Acupuncture, a distinctive technique in traditional Chinese medicine, has emerged as a crucial component of comprehensive management due to its holistic regulatory effects, multi-target efficacy, and minimal side effects. This study systematically reviewed domestic and international databases to analyze acupuncture’s mechanisms through six dimensions: monoamine receptor systems, neurotrophic factors, inflammatory immunity, brain-gut microbiota axis, HPA axis, and neural network remodeling. The current situation and operation points of electroacupuncture, hairpin, abdominal needle, fire needle and combined plan are listed respectively, in order to provide reference for the subsequent clinical pathway optimization and evidence-based practice.
文章引用：王莹, 张淼. 针刺治疗卒中后抑郁的研究概述[J]. 临床医学进展, 2025, 15(9): 1171-1176. https://doi.org/10.12677/acm.2025.1592607

参考文献

[1] Guo, J., Wang, J., Sun, W. and Liu, X. (2022) The Advances of Post-Stroke Depression: 2021 Update. Journal of Neurology, 269, 1236-1249. [Google Scholar] [CrossRef] [PubMed]
[2] Seid, A., Kuma, A., Belete, Y. and Anegagregn, A. (2025) Post‐stroke Depression Prevalence and Associated Factors at Hawassa University Hospital, Ethiopia: A Prospective Cross‐Sectional Study. Psychiatry and Clinical Neurosciences Reports, 4, e70160. [Google Scholar] [CrossRef] [PubMed]
[3] 章显宝, 汪燕, 王震, 等. 针刺对卒中后抑郁大鼠5-HTT、5-HT1AR、NEα2R蛋白表达的影响[J]. 北京中医药大学学报, 2016, 39(9): 783-788.
[4] 袁斌, 吴云川. 针刺结合五音疗法对脑卒中后抑郁模型大鼠神经行为及不同脑区5-HT、NE含量的影响[J]. 时珍国医国药, 2021, 32(8): 2025-2028.
[5] 马青素, 高岚, 郭宁, 等. 脑卒中患者血清BDNF、OPN、AngⅡ水平与焦虑/抑郁的关系[J]. 国际精神病学杂志, 2023, 50(3): 480-482+490.
[6] Xie, J., Li, J., Sun, Q. and Jiang, J. (2025) Clinical Efficacy of Mind-Regulating Acupuncture on Post-Stroke Depression Based on the “Microbiota-Gut-Brain Axis” Theory: A Randomized Controlled Study. Neuropsychiatric Disease and Treatment, 21, 1349-1358. [Google Scholar] [CrossRef] [PubMed]
[7] Wen, H., Weymann, K.B., Wood, L. and Wang, Q.M. (2019) Inflammatory Signaling in Post-Stroke Fatigue and Depression. European Neurology, 80, 138-148. [Google Scholar] [CrossRef] [PubMed]
[8] Hu, J., Wang, L., Fan, K., Ren, W., Wang, Q., Ruan, Y., et al. (2021) The Association between Systemic Inflammatory Markers and Post-Stroke Depression: A Prospective Stroke Cohort. Clinical Interventions in Aging, 16, 1231-1239. [Google Scholar] [CrossRef] [PubMed]
[9] Li, M., Ran, D., Yang, X., Wang, Y., Zhu, Q., Song, X., et al. (2024) Efficacy of Acupuncture in the Treatment of Post-Stroke Depression: A Study Protocol of a Randomized Controlled Trial. PLOS ONE, 19, e0303162. [Google Scholar] [CrossRef] [PubMed]
[10] Liang, S., Wu, X., Hu, X., Wang, T. and Jin, F. (2018) Recognizing Depression from the Microbiota-Gut-Brain Axis. International Journal of Molecular Sciences, 19, Article 1592. [Google Scholar] [CrossRef] [PubMed]
[11] Han, Q., Fu, Y., Le, J., Pilot, A., Cheng, S., Chen, P., et al. (2021) Electroacupuncture May Alleviate Behavioral Defects via Modulation of Gut Microbiota in a Mouse Model of Parkinson’s Disease. Acupuncture in Medicine, 39, 501-511. [Google Scholar] [CrossRef] [PubMed]
[12] Han, W., Wang, N., Han, M., Ban, M., Sun, T. and Xu, J. (2022) Reviewing the Role of Gut Microbiota in the Pathogenesis of Depression and Exploring New Therapeutic Options. Frontiers in Neuroscience, 16, Article ID: 1029495. [Google Scholar] [CrossRef] [PubMed]
[13] Jiang, H., Deng, S., Zhang, J., Chen, J., Li, B., Zhu, W., et al. (2023) Acupuncture Treatment for Post-Stroke Depression: Intestinal Microbiota and Its Role. Frontiers in Neuroscience, 17, Article ID: 1146946. [Google Scholar] [CrossRef] [PubMed]
[14] Wang, S., Sun, H., Liu, S., Wang, T., Guan, J. and Jia, J. (2016) Role of Hypothalamic Cannabinoid Receptors in Post-Stroke Depression in Rats. Brain Research Bulletin, 121, 91-97. [Google Scholar] [CrossRef] [PubMed]
[15] Lam Ching, W., Li, H.J., Guo, J., Yao, L., Chau, J., Lo, S., et al. (2023) Acupuncture for Post-Stroke Depression: A Systematic Review and Network Meta-Analysis. BMC Psychiatry, 23, Article No. 314. [Google Scholar] [CrossRef] [PubMed]
[16] Wu, X., Xu, K., Li, T., Wang, L., Fu, Y., Ma, Z., et al. (2024) Abnormal Intrinsic Functional Hubs and Connectivity in Patients with Post-Stroke Depression. Annals of Clinical and Translational Neurology, 11, 1852-1867. [Google Scholar] [CrossRef] [PubMed]
[17] 李文鑫, 何聪, 刘征. 针刺治疗脑卒中后抑郁机制研究进展[J]. 环球中医药, 2024, 17(8): 1679-1684.
[18] 宋雯雯, 曹志坚, 林江南, 等. 脑梗死后抑郁患者后扣带回及默认网络功能连接研究[J]. 浙江临床医学, 2020, 22(8): 1096-1098.
[19] 刘可妍, 杨可钦, 赵彬, 等. 针刺治疗脑卒中后抑郁的多模态MRI研究进展[J]. 磁共振成像, 2025, 16(3): 109-115.
[20] 姬宇航. 电针联合五行音乐疗法治疗卒中后抑郁的临床疗效观察[D]: [硕士学位论文]. 武汉: 湖北中医药大学, 2024.
[21] 孟凡萍, 陆静珏, 周一心, 等. 电针联合重复经颅磁刺激治疗老年中重度卒中后抑郁的临床随机对照试验研究[J]. 老年医学与保健, 2023, 29(4): 696-699+715.
[22] 刘艳芳, 杨敏, 安琪, 等. 方氏头针调神三步法治疗缺血性脑卒中后抑郁随机对照试验[J]. 针灸临床杂志, 2024, 40(7): 12-17.
[23] 房铭, 陈晓, 孙丽莉, 等. 头针久留针法治疗脑卒中后抑郁的临床观察[J]. 中国实用医药, 2023, 18(21): 127-130.
[24] 任志宏. 头针针刺双侧足运感区、精神情感区治疗卒中后抑郁的临床研究[D]: [硕士学位论文]. 太原: 山西省中医药研究院, 2020.
[25] 张娥铿, 王婧, 张瑾. 腹针疗法治疗卒中后抑郁症临床研究[J]. 中医学报, 2016, 31(10): 1623-1625.
[26] 孙妍, 高扬, 王润泽, 等. 调神运枢法治疗卒中后抑郁对肠道菌群和其代谢物与相关神经递质的影响: 随机对照试验[J]. 针灸临床杂志, 2024, 40(1): 33-38.
[27] 徐婵娟. 火针点刺五心穴治疗中风后抑郁的临床疗效观察[D]: [硕士学位论文]. 哈尔滨: 黑龙江中医药大学, 2020.
[28] 田静. 火针点刺涌泉穴、少冲穴治疗心肾不交型中风后抑郁的疗效观察[D]: [硕士学位论文]. 哈尔滨: 黑龙江中医药大学, 2019.

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