化瘀通络灸联合低频重复经颅磁刺激对脑卒中后轻、中度抑郁患者的影响OACSTPCD

Objective To observe the effect of Huayu Tongluo moxibustion combined with low-frequency repetitive transcra-nial magnetic stimulation(rTMS)on depressive symptoms,neurological deficits and sleep efficiency in patients with mild to moder-ate post-stroke depression(PSD).Methods A total of 40 patients with mild to moderate PSD in the First Affiliated Hospital of An-hui University of Chinese Medicine from January 2022 to October 2023 were randomly divided into control group and observation group,with 20 cases in each group.Both groups received routine treatment and rehabilitation training.The control group received low-frequency rTMS treatment in addition to the routine treatment and rehabilitation training,with a stimulation frequency of 1 Hz,a stimulation intensity of 80%motor threshold(MT),a stimulation duration of 10 s,an interval time of 2 s,and a total of 1 000 pulses.The observation group received Huayu Tongluo moxibustion therapy[pressure moxibustion at Baihui acupoint(GV 20),suspension moxibustion at Shenting(GV 24)acupoint and Dazhui acupoint(GV 14)]in addition to the treatment of the control group.Both groups were treated once a day,five times a week for three weeks.Before and after treatment,the Hamilton depression scale(HAMD),patient health questionnaire-9(PHQ-9),and latency and amplitude of event related potential P300 were used to evaluate the symptoms and severity of depression;the National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the degree of neurological deficits;the Pittsburgh sleep quality index(PSQI)was used to evaluate patient sleep efficiency;and the differences in adverse reactions between the two groups were compared.Results(1)Symptoms and severity of depression:compared with that before treatment,the HAMD and PHQ-9 scores decreased significantly in both groups after treatment,the latency of event related potential P300 decreased significantly and the amplitude of event related potential P300 increased significantly,and the differ-ences were statistically significant(P<0.05).Compared with the control group,HAMD and PHQ-9 scores were lower in the observa-tion group after treatment,the latency of event related potential P300 was shorter and the amplitude of event related potential P300 was higher,and the differences were statistically significant(P<0.05).(2)Degree of neurological deficits:compared with that before treatment,NIHSS score decreased significantly in both groups after treatment(P<0.05).Compared with the control group,NIHSS score were lower in the observation group after treatment,and the differences were statistically significant(P<0.05).(3)Sleep effi-ciency:compared with that before treatment,sleep efficiency improved significantly in both groups after treatment,and the differences were statistically significant(P<0.05).There was no statistically significant difference in sleep efficiency between the control group and the observation group after treatment(P>0.05).(4)Adverse reactions:No adverse reactions occurred in both group.Conclu-sion Huayu Tongluo moxibustion combined with low-frequency rTMS can effectively improve depression symptoms,neurological deficits,and sleep efficiency of patients with mild to moderate PSD,which is recommended for clinical promotion and application.