针刺十三鬼穴联合头部刮痧治疗卒中后抑郁的临床疗效研究

Clinical Efficacy Study of Acupuncture at Thirteen Ghost Points Combined with Head Scraping Therapy on Post-Stroke Depression

摘要: 目的：观察针刺十三鬼穴联合头部刮痧治疗卒中后抑郁(post stroke depression, PSD)的临床疗效。方法：选取PSD患者62例，将其随机分为观察组(31例)与对照组(31例)。观察组采用针刺十三鬼穴联合头部刮痧治疗，对照组采用常规针刺法治疗。两组均每日治疗1次，连续治疗6 d，休息1 d后再进行下一疗程治疗，共治疗4个疗程。比较治疗前后汉密尔顿抑郁量表(HAMD)、患者健康问卷(PHQ-9)和美国国立卫生研究院卒中量表(NIHSS)评分的变化，采用Pearson相关性分析检验神经功能恢复和抑郁状态恢复的相关性。结果：治疗后，观察组总有效率94%，优于对照组的74% (P < 0.05)；两组治疗后HAMD评分、PHQ-9评分和NIHSS评分均较治疗前明显降低(P < 0.01)，且观察组明显优于对照组(P < 0.01)。进行pearson相关分析结果表明两组患者神经功能恢复状况及抑郁状态恢复存在较强的正相关，观察组：(r = 0.529, P < 0.01)；对照组：(r = 0.682, P < 0.01)。结论：针刺十三鬼穴联合头部刮痧治疗卒中后抑郁疗效显著，能够有效改善患者的抑郁症状及神经功能缺损程度，且患者神经功能的恢复与抑郁状态的改善均具有一致性，具有较高的临床应用价值。

Abstract: Objective: To evaluate the clinical efficacy of acupuncture at the Thirteen Ghost Points combined with head scraping therapy in the treatment of post-stroke depression (PSD). Methods: Sixty-two PSD patients were randomly assigned to an observation group (n = 31) and a control group (n = 31). The observation group received acupuncture at the Thirteen Ghost Points combined with head scraping therapy, while the control group underwent conventional acupuncture. Both groups received daily treatment for 6 consecutive days, followed by a 1-day rest period before commencing the next treatment cycle, totaling 4 treatment cycles. Changes in Hamilton Depression Rating Scale (HAMD), Patient Health Questionnaire-9 (PHQ-9), and National Institutes of Health Stroke Scale (NIHSS) scores were compared before and after treatment. Pearson correlation analysis was used to assess the relationship between neurological function recovery and depressive state recovery. Results: After treatment, the total effective rate in the observation group was 94%, significantly higher than the 74% in the control group (P < 0.05). The HAMD, PHQ-9, and NIHSS scores in both groups were significantly lower after treatment compared to before treatment (P < 0.01), with the observation group showing significantly better outcomes than the control group (P < 0.01). Pearson correlation analysis revealed a strong positive correlation between neurological recovery and depressive recovery in both groups: observation group (r = 0.529, P < 0.01); control group (r = 0.682, P < 0.01). Conclusion: Acupuncture at Thirteen Ghost Points combined with head scraping therapy has a significant therapeutic effect on post-stroke depression. It effectively alleviates depressive symptoms and reduces neurological deficits in patients. Moreover, the recovery of neurological function and the improvement of depressive symptoms were consistent, highlighting its high clinical application value.