| 钟寅燕.醒脑开窍针法联合基础抗癫痫、氟西汀治疗癫痫后抑郁障碍的临床研究[J].浙江中西医结合杂志,2020,30(11): |
| 醒脑开窍针法联合基础抗癫痫、氟西汀治疗癫痫后抑郁障碍的临床研究 |
| Clinical study of Xingnao Kaiqiao acupuncture combined with basic antiepileptic, fluoxetine in treatement of post-epileptic depression disorder |
| 投稿时间：2020-03-16 修订日期：2020-05-29 |
| DOI： |
| 中文关键词: 醒脑开窍针法 癫痫 抑郁障碍 HAMD评分 TESS评分 神经递质 QOLIE-31评分 |
| 英文关键词:Xingnao Kaiqiao Acupuncture Epilepsy Depressive disorder HAMD score TESS score Neurotransmitter QOLIE-31 score |
| 基金项目:国家自然科学基金青年科学基金项目（81603678） |
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| 中文摘要: |
| 目的 探讨醒脑开窍针法联合基础抗癫痫、氟西汀治疗癫痫后抑郁障碍的临床疗效及对汉密尔顿抑郁量表（HAMD）评分、副反应量表（TESS）评分、神经递质水平、癫痫患者生活质量评定量表-31（QOLIE-31）评分的影响。方法 对杭州市余杭区第一人民医院2017年11月至2019年9月癫痫后抑郁障碍患者60例进行研究，随机数字表法分为对照组（30例）与观察组（30例），对照组给予基础抗癫痫和口服氟西汀胶囊治疗；观察组在对照组的基础上联合醒脑开窍针法治疗。对比分析两组治疗后的临床疗效，治疗前、后的HAMD评分、TESS评分，QOLIE-31评分评价其生活质量，神经递质血浆去甲肾上腺素（NE）、多巴胺（DA）及5-羟色胺（5-HT）水平变化。结果 观察组治疗有效率高于对照组（96.66％ vs 70.00％）（χ2=7.680，P=0.006）；与治疗前比较，两组患者治疗2周、4周、8周后HAMD评分逐渐降低（P<0.05），且同一时间点观察组HAMD评分均低于对照组（P<0.05）；治疗2周、4周、8周后观察组患者TESS评分均低于同一时间点的对照组（P<0.05）；治疗后两组患者的NE、DA和5-HT水平均升高（P<0.05），且观察组的NE、DA和5-HT水平均高于对照组（P<0.05）；观察组治疗后的发作担忧、综合健康状况和生活质量评定、情绪/情感、精力/疲乏、认知功能、社会功能、总分均高于对照组（P<0.05），两组的药物影响得分差异无统计学意义（P>0.05）。结论 醒脑开窍针法联合基础抗癫痫、氟西汀治疗癫痫后抑郁障碍的临床疗效明确，可有效的改善患者神经递质水平及抑郁症状，且副反应较轻，能明显提高患者生活质量。 |
| 英文摘要: |
| Objective: To investigate the Clinical effect of Xingnao Kaiqiao acupuncture combined with basic antiepileptic, fluoxetine on post-epileptic depression disorder and its influence on HAMD, TESS score, neurotransmitter level and QOLIE-31 score. Methods: From November 2017 to September 2019, 60 patients with post-epilepsy depression disorder in the first people's Hospital of Yuhang District in Hangzhou City were divided into control group (30 cases) and observation group (30 cases) by random number table method. The cases in the control group were treated with basic anti-epilepsy and oral fluoxetine capsule, while the cases in the observation group were treated with Xingnao Kaiqiao acupuncture on the basis of the control group. The clinical efficacy, Hamilton Depression Scale (HAMD) and TESS scores, QOLIE-31, plasma norepinephrine (NE), dopamine (DA) and serotonin (5-HT) levels were compared and analyzed before and after treatment between two groups. Results: The effective rate of the observation group was higher than that of the control group (96.66% vs 70.00%) (χ2=7.680, P=0.006). Compared with before treatment, the HAMD score of the two groups decreased gradually after 2, 4 and 8 weeks of treatment (P<0.05), and the HAMD score of the observation group was lower than that of the control group at the same time point (P<0.05). After 2 weeks, 4 weeks and 8 weeks of treatment, the TESS score of the observation group was lower than that of the control group at the same time point (P < 0.05). The levels of NE, DA and 5-HT in the two groups were significantly increased after treatment, and the levels of NE, DA and 5-HT in the observation group were better than those in the control group (P<0.05). After treatment, the incidence of anxiety, comprehensive quality of life, emotion/emotion, energy/fatigue, cognitive function, social function and total score in the observation group were higher than those in the control group (P<0.05). There was no significant difference in the scores of drug effects between the two groups (P>0.05). Conclusion: The clinical effect of Xingnao Kaiqiao Acupuncture combined with basic antiepileptic, fluoxetine in the treatment of post-epilepsy depressive disorder is clear. It can effectively improve the level of neurotransmitters and depressive symptoms of patients with mild side effects, and can significantly improve the quality of life of patients. |
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