手针与假针对脑卒中后抑郁症患者的影响：随机临床试验。

IF 3.9 3区医学 Q1 CLINICAL NEUROLOGY

Neurology and Therapy Pub Date : 2024-12-01 Epub Date: 2024-10-25 DOI:10.1007/s40120-024-00672-z

Conghui Wei, Jinling Chen, Qu Yang, Jingjing Xu, Qingsong Li, Fulin Li, Yu Liu, Jun Luo

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引用次数: 0

摘要

背景：脑卒中后抑郁（PSD）是脑卒中患者普遍存在的精神并发症，严重降低了脑卒中幸存者的生活质量，延迟了其社会功能的恢复。临床研究表明，针灸可作为治疗 PSD 的替代方法。本研究旨在探讨针灸治疗 PSD 患者的安全性、有效性和脑电图（EEG）机制：方法：2022 年 10 月 28 日至 2023 年 5 月 16 日，在南昌大学第二附属医院进行了单中心、单盲、随机临床试验。符合条件的 56 名受试者被随机分配到两组，即人工针灸组（MA）和假针灸组（SA）。主要结果是汉密尔顿抑郁量表-24（HAMD-24），次要结果包括匹兹堡睡眠质量指数（PSQI）、美国国立卫生研究院卒中量表（NIHSS）、巴特尔指数、脑电图功率谱和脑电图虚相干（iCOH）：与 SA 组相比，MA 组在第 6 周时的 HAMD-24、NIHSS、PSIQ 和 Barthel 指数均有显著改善。MA 组的总改善率为 85.71%，SA 组为 28.57%。治疗 6 周后，与 SA 组相比，MA 组的α和β波段功率谱明显增加，而 delta 和 theta 波段功率谱明显减少。iCOH分析显示，MA组在四个波段的功能连接性明显高于SA组：结论：针灸可作为 PSD 患者的辅助治疗手段，改善患者的神经功能缺损、睡眠质量和抑郁状况。同时，针灸治疗 PSD 患者的机制可能是通过降低慢波功率谱和提高快波功率谱，增强大脑功能连接：中国临床试验注册中心（ChiCTR2200065112/2022-10-28）。

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Effects of Manual Acupuncture Versus Sham Acupuncture in patients with Post-Stroke Depression: A Randomized Clinical Trial.

Background: Post-stroke depression (PSD) is a prevalent psychiatric complication in stroke patients, severely reducing quality of life and delaying social recovery in stroke survivors. Clinical studies have shown that acupuncture can be used as an alternative approach for PSD. The aim of this study was to examine the safety, efficacy, and electroencephalogram (EEG) mechanism of acupuncture in treating PSD patients.

Methods: From October 28, 2022 to May 16, 2023, this single-center, single-blind, randomized clinical trial was conducted at the Second Affiliated Hospital of Nanchang University. A total of 56 eligible subjects were assigned in a random manner, with an equal distribution between two groups: the manual acupuncture (MA) group and the sham acupuncture (SA) group. The primary outcome was the Hamilton Depression Scale-24 (HAMD-24); the secondary outcomes included the Pittsburgh Sleep Quality Index (PSQI), the National Institutes of Health Stroke Scale (NIHSS), the Barthel index, EEG power spectrum, and EEG imaginary coherent (iCOH).

Results: Compared to the SA group, the MA group exhibited significant improvements in HAMD-24, NIHSS, PSIQ, and Barthel index at week 6. The total improvement rate was 85.71% in the MA group and 28.57% in the SA group. After 6 weeks of treatment, the alpha and beta bands power spectrum increased significantly, while the delta and theta bands power spectrum decreased significantly in the MA group compared to the SA group. The iCOH analysis showed that the MA group had significantly higher functional connectivity in the four bands than the SA group.

Conclusions: Acupuncture might be regarded as an adjunctive treatment for PSD patients with improvements in their neurological deficits, sleep quality, and depression. Meanwhile, the mechanism of acupuncture in treating PSD patients may be through decreasing the slow wave power spectrum and increasing the fast wave power spectrum, and enhancing brain functional connectivity.

Trial registration: Chinese Clinical Trial Registry (ChiCTR2200065112/2022-10-28).

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来源期刊

Neurology and Therapy CLINICAL NEUROLOGY-

CiteScore

5.40

自引率

8.10%

发文量

103

审稿时长

6 weeks

期刊介绍： Aims and Scope Neurology and Therapy aims to provide reliable and inclusive, rapid publication for all therapy related research for neurological indications, supporting the timely dissemination of research with a global reach, to help advance scientific discovery and support clinical practice. Neurology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of neurological and psychiatric therapies, (also covering surgery and devices). Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial designs, communications and letters. 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