【目的】 观察通督调神针法联合盐酸氟西汀片治疗中风后抑郁的临床疗效。【方法】 选取2023年10月至2024年10月佛 山市南海区妇幼保健院中医科和康复科收治的90例明确诊断为中风后抑郁的患者为研究对象。按照随机数字表法将患者随 机分为观察组与对照组，每组45例。对照组给予盐酸氟西汀片治疗，观察组在对照组治疗的基础上，给予通督调神针法治 疗，连续治疗8周。治疗8周后，评价2组临床疗效。观察2组患者治疗前后中医证候积分、美国国立卫生研究院卒中量表 （NIHSS）评分的变化情况，以及汉密顿抑郁量表（HAMD）评分的情况。比较2组患者治疗前后去甲肾上腺素（NE）、5-羟色胺 （5-HT）、多巴胺（DA）水平的变化情况。并评价2组的安全性及不良反应的发生情况。【结果】（1）治疗后，2组患者的中医证 候积分、NIHSS评分明显改善（P＜0.05），且观察组在改善中医证候积分、NIHSS评分方面明显优于对照组，差异有统计学 意义（P＜0.05）。（2）治疗后，2组患者的 HAMD 评分明显改善（P＜0.05），且观察组在改善 HAMD 评分方面明显优于对照组， 差异有统计学意义（P＜0.05）。（3）治疗后，2组患者的NE、5-HT、DA水平明显改善（P＜0.05），且观察组在改善NE、5-HT、 DA 水平方面明显优于对照组，差异有统计学意义（P＜0.05）。（4）观察组总有效率为 93.33%（42/45），对照组为 75.56% （34/45）。观察组疗效优于对照组，差异有统计学意义（P＜0.05）。（5）观察组不良反应发生率为 4.44%（2/45），对照组为 11.11%（5/45）。观察组与对照组的不良反应发生率比较，差异无统计学意义（P＞0.05）。【结论】 通督调神针法联合盐酸氟西 汀片治疗中风后抑郁，能有效调节患者的情绪状态，改善患者的临床症状，加速患者损伤神经的修复，还能改善患者的神 经递质水平，且安全性好，临床疗效显著。

Objective To observe the clinical efficacy of Mind-Regulating and Meridians-Dredging Acupuncture method combined with Fluoxetine Hydrochloride Tablets in treating post-stroke depression （PSD）. Methods A total of 90 patients diagnosed with PSD were enrolled from the Department of Traditional Chinese Medicine and the Department of Rehabilitation of Foshan Nanhai Maternal and Child Health Hospital between October 2023 and October 2024. They were randomly divided into an observation group and a control group using a random number table，with 45 patients in each group. The control group received Fluoxetine Hydrochloride Tablets，while the observation group received Mind-Regulating and Meridians-Dredging Acupuncture method in addition to the control group’s treatment. The treatment course for both groups was 8 consecutive weeks. After 8 weeks， the clinical efficacy was evaluated. Changes in TCM syndrome scores， National Institutes of Health Stroke Scale （NIHSS） scores， and Hamilton Depression Scale （HAMD） scores were observed before and after treatment in both groups. Changes in levels of norepinephrine （NE）， serotonin （5-HT）， and dopamine （DA） were also compared before and after treatment. Safety and the incidence of adverse reactions were evaluated in both groups. Results（1）After treatment，TCM syndrome scores and NIHSS scores were significantly improved in both groups （P＜0.05），and the improvement in the observation group was significantly superior to that in the control group， with a statistically significant difference （P＜0.05）.（2）HAMD scores were significantly improved in both groups after treatment （P＜0.05），and the improvement in the observation group was significantly greater than that in the control group， with a statistically significant difference （P＜0.05）. （3）NE， 5-HT， and DA levels were significantly improved in both groups after treatment （P＜0.05），and the improvement in the observation group was significantly superior to that in the control group，with statistically significant differences （P＜0.05）.（4）The total effective rate was 93.33% （42/45） in the observation group and 75.56% （34/45） in the control group. The efficacy of the observation group was superior to that of the control group， and the difference was statistically significant （P＜0.05）.（5）The incidence of adverse reactions was 4.44% （2/45） in the observation group and 11.11% （5/45） in the control group. There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group （P＞0.05）. Conclusion Mind-Regulating and Meridians-Dredging Acupuncture method combined with Fluoxetine Hydrochloride Tablets effectively regulates emotional status， improves clinical symptoms， accelerates the repair of damaged nerves， and ameliorates neurotransmitter levels in patients with PSD，demonstrating good safety and significant clinical efficacy.

R246.9

广东省自然科学基金面上项目（编号：2024A1515012282）