目的评价我国已发表的针灸治疗卒中后抑郁RCT文献的质量(截止2004年7月)。方法电子检索MEDLINE(1966-2004)CBM(1978-2004.7)和Cochrane L ibrary 2004年第2期临床对照试验中心注册库(CENTRAL),手工检索《中国针灸》(1981-2004.7)、《针刺研究》(1976-2004.7)、《上海针灸杂志》(1982-2004.7)、《针灸临床杂志》(1985-2004.7),纳入符合“卒中后抑郁”的针灸临床随机对照试验研究(RCT)文献,对其进行质量评价。结果共检索到相关文献162篇,符合纳入标准11篇,仅3篇文献交待了随机方法,无1篇文献提及随机化隐藏及样本估算依据。提到基线可比的有5篇,仅1篇采用单盲法。2个研究中存在失访,但均未做意向性治疗分析处理,仅1项研究随访1年。统计方法正确的5篇,错误的2篇,不能肯定的4篇。结论我国针灸治疗卒中后抑郁的高质量RCT数量较少,研究质量的整体水平有待提高。
Objective To observe the therapeutic effect of electroacupuncture （EA） of ＂Niwan Bazhen＂ points in the treatment of post-stroke depression. Methods A total of 66 post-stroke depression patients were randomized into treatment group （EA＋oral administration of Prozac-20, n =31 ） and control group （o- ral administration of Prozac-20, 20 mg/d, 28 days altogether, n =30）. For patients of treatment group, EA （2/100 Hz, a tolerable stimulation strength） was applied to ＂Niwan Bazhen＂ points [Baihui （百会 GV20）, etc. ] for 30 min, once daily, （except weekends） continuously for one month. Halmiton Rating Scale （HAMD） for Depression and Chinese Scale for Stroke （CSS） were used to evaluate the therapeutic effect. Results After the treatment, of the 30 and 31 cases in control and treatment groups, 4 and 6 were cured, 10 and 14 experienced marked improvement.in their symptoms, 6 and 7 had an improvement, 6 and 4 failed, with the cure＋ markedly effective rates being 46.7% and 64.5% respectively. The therapeutic effect of treatment group was significantly superior to that of control group （ P〈0.05）. The decreased values of both HAMD and C,,SS of treatment group were remarkably lower than those of control group （P〈0.01,0.05） . Conclusion EA of ＂Niwan Bazhen＂ points is an effective remedy for post-stroke depression.
