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1、提要目的:临床观察冠心病合并抑郁患者,通过实验室检查和临床评价,观察针刺对冠心病合并抑郁患者的疗效,并初步探讨其机制,为中医针刺治疗冠心病合并抑郁患者提供理论基础和临床依据,以期为患者提供新的治疗方法。方法:选择冠心病合并抑郁症患者67例,随机分为治疗组和对照组,对照组仅给予冠心病的二级防治治疗(具体参照07版西医内科学)和抗抑郁的心理疏导、药物治疗。治疗组在对照组基础上,加用针刺疗法,以督脉、手足厥阴经、手少阴经为主,解郁行气,活血止痛,养心安神为治法,选穴有心俞、内关、厥阴俞、膻中、水沟、神门、太冲、丰隆、血海、膈俞、三阴交,两侧取穴,每日1次,留针20min。治疗组和对照组均以
2、6周为1疗程,连续治疗4个疗程,即结束治疗。观察两组在一般资料、相关危险因素(血脂、血糖、Hcy、Hs-CRP)、抑郁评分、心绞痛积分、中医症状学积分等上的差异。结果:通过两组统计分析,得出治疗组和对照组在血脂水平(TC、TG、LDL-c)、Hcy、Hs-CRP、抑郁评分有统计学差异(P<0.05),尤其在TG、LDL-c上有显著统计学差异(P<0.01)。结论:针刺治疗冠心病合并抑郁患者有明显疗效,可以降低血脂、Hcy、Hs-CRP、改善患者抑郁症状。尽管两组在空腹血糖、心绞痛积分、中医症状学积分比较上无统计学差异,但统计过程中发现治疗组均值要小于对照组,说明针刺仍然能够降低血糖水
3、平,改善冠心病合并抑郁患者的临床症状,促进预后。因此,针刺治疗冠心病合并抑郁患者有明显的临床疗效,不仅能降低其危险指标,而且能改善患者临床症状,符合临床实际,值得借鉴。关键词针刺;冠心病;抑郁症;危险因素TheanalysisandclinicalresearchofAcupunctureforcoronaryheartdiseasepatientswithdepressionSpeciality:InternalMedicineofTCMAuthor:XueWeiweieTutor:professorWangyinggAbstractObjective:Theaimsofthepr
4、ojectisthroughthelaboratoryandclinicalevaluationtoobservethecurativeeffectoftheacupuncturemechanism,andtoprovidethetheorybasisandclinicalevidencefortheTCMacupuncturetreatmentofcoronaryheartdiseasepatientswithdepression,soastoprovidepatientswithnewtreatments.Method:choose67casesofpatientswithcor
5、onaryheartdiseasewithdepression,dividedintotheexperimentalgroupandcontrolgroup.Thecontrolgroupislimitedtowesternmedicineroutinetreatment.Thetreatmentgroupaddswithacupuncturetopointsofgovernorvessel,meridianofhandandfootjueyin,heartmeridianofhandshaoyin,withjieyuxingqi,huoxuezhitong,yangxinanshe
6、n.choosetheacupuncturepointssuchasxinshu,neiguan,jueyinshu,danzhong,xingjian,qimen,xuehai,geshu,sanyinjiao,keeptheneedlesfor20minonceaday.Treatmentgroupandcontrolgroupareinsixweeksforaperiodoftreatment,fourtreatmentlater,thenendthetreatment.Watchthediffencesbettwentwogroupsingeneraldata,related
7、riskfactors(bloodfatandbloodsugar,Hcy,Hs-CRP),depressionrating,anginapectorisintegral,TCMsymptomsandsoon.Results:throughthetwogroupsofstatisticalanalysis,concludestatisticallysignificantdifferences(P<0.01)bettwenthetreatmentgroupa