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目的:观察“治神调髓”针刺法治疗缺血性脑卒中后抑郁的临床疗效.方法:纳入2016年1月至2018年1月的145例缺血性脑卒中后抑郁患者,按照随机数字表法分为2组,其中对照组72例,观察组73例.对照组接受常规缺血性脑卒中治疗加药物治疗,观察组在对照组干预基础上加用“治神调髓”针刺治疗.两组均连续治疗4周.治疗后分析两组临床疗效.治疗前后比较两组神经功能相关评分[汉密顿抑郁量表(HAMD)、临床神经功能缺损量表(CNDS)、日常生活活动(ADL)、Fugl-Meyer量表(FMA)及巴氏指数(BI)评分],肾上腺皮质醇(CORT)和促肾上腺皮质激素(ACTH)水平,并观察治疗期间不良反应发生情况.结果:观察组临床总有效率为82.2％,显著高于对照组的66.7％(P<0.05).两组治疗后HAMD及CNDS评分均较治疗前显著降低(均P<0.05),ADL、FMA及BI评分均较治疗前显著升高(均P<0.05);观察组治疗后HAMD及CNDS评分显著低于对照组(均P<0.05),ADL、FMA及BI评分显著高于对照组(均P<0.05).两组治疗后CORT及ACTH水平均较治疗前显著降低(均P<0.05),观察组治疗后CORT及ACTH水平显著低于对照组(均P0.05).结论:相比于单独西药治疗,药物加“治神调髓”针刺治疗可促进缺血性脑卒中后抑郁患者神经功能恢复,降低CORT和ACTH水平,提高临床疗效,有较高安全性.“,”Objective: To observe the clinical efficacy of Zhi Shen Tiao Sui (regulating the mind and marrow) needling in treating depression after ischemic stroke. Methods: A total of 145 patients with depression after ischemic stroke were recruited between January 2016 and January 2018 and divided into two groups using random number table method, with 72 cases in the control group and 73 cases in the observation group. The control group received conventional treatment for ischemic stroke and medication, while the observation group was given additional Zhi Shen Tiao Sui acupuncture. The two groups were treated for 4 successive weeks. Clinical efficacy was analyzed after treatment. The neurological function pertinent scores [Hamilton depression scale (HAMD), clinical neurological deficit score (CNDS), activities of daily living (ADL), Fugl-Meyer assessment scale (FMA) and Barthel index (BI) scores], as well as the levels of cortisol (CORT) and adrenocorticotropic hormone (ACTH) were recorded in the two groups. Adverse reactions that occurred during treatment were also observed. Results: The clinical total effective rate was 82.2％ in the observation group, significantly higher than 66.7％ in the control group (P<0.05). After treatment, the HAMD and CNDS scores were markedly reduced in both groups (all P<0.05), and the ADL, FMA and BI scores were markedly increased (all P<0.05). The HAMD and CNDS scores were significantly lower in the observation group than in the control group after treatment (both P<0.05), and the ADL, FMA and BI scores were significantly higher in the observation group than in the control group (all P<0.05). The levels of CORT and ACTH declined significantly after treatment in the two groups (all P<0.05), and were markedly lower in the observation group than in the control group (both P0.05). Conclusion: Compared with sole use of Western medication, medication combined with Zhi Shen Tiao Sui acupuncture can promote the recovery of neurological function, down-regulate the levels of CORT and ACTH and enhance the clinical efficacy in treating patients with depression after ischemic stroke, with a relatively high safety rating.