电针焦虑方治疗中风后焦虑障碍的临床疗效评价
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摘要
背景
中风是指现代西医学中的脑血管病,中风的发病率、复发率、致残率及致死率都很高,占我国人口死因的第二位。中风后焦虑障碍是脑血管病常见的长期并发症,国内外流行病学研究显示其发病率为20-40%。该病是一种常见和持久的痛苦,尤其是中度以上的中风后焦虑,直接干扰中风患者的生活质量和躯体、认知功能恢复,甚至可引起再发。因此,及早关注及治疗中风后焦虑将有利于提高生活质量及改善功能恢复,并降低致残率及死亡率。近10年来,中风后情绪障碍成为专科医生研究的热点,中风后抑郁障碍的临床研究相对较为成熟,中风后焦虑障碍的研究较少,也较不完善。国外的研究多集中在西药的疗效、不良反应的对比研究,以及对躯体功能恢复干预方面的研究。由于西药的副作用大,起效慢,需长期服用,撤药困难,价格较贵,依从性差等多方面原因,使得患者多数不愿接受规范的西药抗焦虑治疗,往往贻误病情。因此寻找一种疗效确切,安全易接受的治疗手段势在必行。
相对于西药而言,针刺治疗立足于整体脏腑调节,即可调节情绪,又可改善情绪导致的躯体症状,且躯体症状的改善有可能先于情绪症状,而西药治疗恰恰相反,一定是通过改善情绪继而改善由此引起的躯体症状。并且针刺还具有简便易行、无依赖、安全易接受等特点。不同于由东方病耻感引起的对药物的抵触心理,多数焦虑患者对针刺易于接受,尤其是中风后患者。通过近10年的文献复习发现目前多数研究存在样本量偏小,观察项目有限,未规范随机等问题。未见到针药对比的起效时间及随访研究。
目的
本研究旨在通过严格的随机对照研究,对电针焦虑方治疗焦虑的近期疗效,起效时间、随访及安全性进行评价。
方法
所有病人均来源于中国中医科学院广安门医院针灸科病房2010年10月—2012年2月的住院中风患者,共筛选患者672例,符合入选标准140例,进行随机分入焦虑穴方组70例,药物组70例。焦虑穴方组取穴为：百会、印堂、四神聪、太阳、内关、神门。于双太阳穴,百会及印堂穴针柄连接G6805治疗仪两电极,高频100HZ,连续波形,电流幅度以患者能忍受为度。每日一次,每次30分钟,每周五次,疗程共四周。药物组：规范化口服SSRI盐酸帕罗西汀片,10mgQD,4天后服20mg QD。疗程共四周。两组的基础治疗一致,西药治疗均采用脑血管病的规范治疗,基础础针灸治疗以改善肢体功能为主,不取头部穴位及神门、内关穴。
在治疗第一、二、四周应用汉密尔顿焦虑量表(HAMA)、Zung氏焦虑自评量表(SAS)评价中风后焦虑的近期疗效、起效时间,同时应用汉密尔顿焦虑量表(HAMA)评分中三因子评分来细化评估焦虑穴方组的优势所在。在第四周末用临床疗效总评量表-疗效指数(CGI-EI)评价两组的疗效指数,应用生活自理能力评定Barthel指数(BI)评估两组治疗前后患者躯体功能恢复情况。在治疗后3个月、6个月时以电话随访的方式用汉密尔顿焦虑量表(HAMA)进行中期疗效评估。对入组患者性别、年龄、婚况、病程、陪护人员、家庭经济状况、患者文化程度等方面进行焦虑的严重程度的相关性对比。
结果
1.近期疗效
总共纳入140例患者,其中焦虑穴方组70例,脱落2例；药物组70例,脱落7例。故最终完成观察焦虑穴方组68例,药物组63例。
焦虑穴方组与药物组在性别、年龄、病程、病情轻重等方面对比无统计学差异(P>0.05),基线一致,具可比性。
焦虑穴方组总有效率为84.3%,药物组总有效率为82.9%,两组对比疗效相当(P>0.05)。焦虑穴方组治疗前后HAMA评分明显下降,经配对t检验,具有极显著性差异(P<0.001),说明电针对于改善焦虑方面疗效肯定。药物组治疗前后HAMA评分明显下降,具有统计学差异(P<0.05),两组治疗后对比,经独立样本t检验,无显著差异(P>0.05),表明两组疗效相当。
HAMA中包含精神性焦虑、躯体性焦虑、睡眠因子等三个因子,可以通过两组对三个因子的影响程度来明确电针焦虑方在治疗焦虑方面的优势所在。精神性焦虑因子、睡眠因子方面焦虑穴方组与药物组治疗前后均有显著性差异(P<0.05),但两组间在治疗后无显著性差异(P>O.05),说明疗效相当。躯体性焦虑因子两组治疗前后均有极显著性差异(P<0.01),疗后呈显著性差异(P<0.05),说明焦虑穴方组在治疗躯体性焦虑方面较药物有一定优势。
Zung氏焦虑自评量表(SAS)是患者自评量表,旨在从患者角度评估疗效。焦虑穴方组及药物组治疗前后SAS评分均明显下降,具有显著性差异(P<0.05),西组治疗后对比,无显著差异(P>0.05),表明两组疗效相当。
临床疗效总评量表疗效指数(Clinical Global Impression. CGI-EI)两组对比有显著统计学差异(P<0.05),提示焦虑穴方组在疗效指数方面有优势。
BI评分反映了中风患者躯体功能恢复的程度,两组治疗前后BI评分均有显著提高,具备显著性差异(P<0.05),但两组间疗后对比不具显著性差异(P>0.05),说明两组对患者的躯体功能恢复改善程度相当。对焦虑穴方组及药物组BI评分的提高与HAMA减分率的相关性进行研究,发现两组均有相关性,具显著性差异(P<0.05),提示BI评分提高者焦虑疗效好。
2.起效时间研究
焦虑穴方组与药物组治疗2周后,两组HAMA评分较之疗前均有显著性差异(P<0.05),焦虑穴方组评分下降显著,与药物组比较有显著性差异(P<0.05),提示焦虑穴方组起效快。
焦虑穴方组与药物组治疗2周后,两组SAS评分较之疗前均有极显著性差异(P≤0.01),焦虑穴方组评分下降显著,与药物组比较有极显著性差异(P≤0.01),提示焦虑穴方组起效快。
焦虑穴方组与药物组治疗1周后,躯体性焦虑因子焦虑穴方组较疗前即呈现显著性差异(P<0.05),2周时呈极显著差异(P<0.01)且与药物组对比有统计学差异(P<0.05),提示焦虑穴方组在改善躯体焦虑方面1周即起效,较药物组有优势。在精神性焦虑因子方面两组均于2周时较疗前评分出现显著性差异(P<0.05),且焦虑穴方组下降明显,组间对比呈显著性差异(P<0.05)提示焦虑穴方组起效快。在睡眠因子方面两组均于两周起效(P<0.05),且疗效相当(P>0.05)
3.治疗后3个月及6个月的随访研究
随访病例焦虑穴方组脱落8例,药物组脱落10例。其中14例为联系方式有误,另焦虑穴方组及药物组分别有2例拒绝受访。故最终完成观察焦虑穴方组60例,药物组53例纳入统计。
焦虑穴方组与药物组在3个月和6个月的HAMA评分分别与治疗前相比仍具统计学差异(P<0.05),而与治疗1个月相比无统计学意义(P>0.05),表明两组患者在半年内焦虑疗效仍就维持。两组患者在3个月及6个月的HAMA评分的组间对比不具有统计学差异(P>0.05),表明两组患者在半年内的焦虑疗效相当。
4.焦虑症状的相关因索分析
中风后焦虑的相关因素分析显示,女性、年龄大于55岁、离异/丧偶者,家庭人均收入低、文化程度高者焦虑程度较高(P<0.05)。而病程、陪护等因素与焦虑病情程度无相关(P>0.05)。
5.安全性评价
采用TESS评定副反应,结果在研究过程中,药物组共有16例出现副反应(其中9例同时出现两种不良反应),占西药组总人数的25.39%,口干出现9例,恶心出现3例,便秘出现6例,头晕出现6例,嗜睡出现1例,实验室检查均未见异常。针刺组仅2例出现不良反应,占治疗组总人数的2.94%,头晕2例,均在休息后自行缓解,未出现滞针、断针、感染等不良反应记录。
结论
电针焦虑方治疗中风后焦虑与药物组近期疗效及中期疗效相当,起效较药物组早,在改善躯体性焦虑方面在疗效和起效时间上均较药物有优势。两组在改善躯体功能障碍方面也疗效相当。焦虑穴方组安全性好于药物组。
Background
Stroke is a one of the most common cause of disability and can have a profound impact on a person's physical, emotional, and social functioning and wellbeing. Following a stroke, individuals can experience a loss in functional ability, barriers to community integration, increases in idle time, social isolation, depression, anxiety, financial and vocational changes, and lower feelings of personal autonomy. Because of that, emotional disorders after stroke become very important. It is a common long-term complication of cerebral vascular disease. Foreign and domestic epidemiological study show that incidences of anxiety disorder in post-stroke patients is from20%to40%. Studies indicated that post-stroke anxiety is the most common psychiatric disorder in stroke complication which will seriously influence the physical rehabilitation. Now the conventional treatment includes medication and psychological treatment. Treatment with benzodiazepines and newer antidepressants is often inadequate because of their limited clinical efficacy and side effects. Psychological treatment is limited due to slow working, uncertain efficacy and time consuming etc. In recent years, more and more researchers start to look for new treatments which have better clinical effect, safe and well-tolerated. Acupuncture treatment may be one of the hot spot for its rapid onset of action, equivalent efficacy and safety. To further investigate the effect of acupuncture treatment which include short and medium term effects on post-stroke anxiety, this study aims to demonstrate through a RCT whether acupuncture produces equivalent result to the result of first-lined antidepressant.
Research objectives
The primary research objective was to observe the clinical effect of electro-acupuncture (EA) treatment on post-stroke anxiety disorder when compared to control group using Paroxetine. The clinical observation included onset time, short-term effect and follow-up. The other objectives were to identify the specific advantage of electro-acupuncture (EA) treatment and to evaluate the safety of both therapies. To evaluate the
Methods
140PSAD patients were randomized into two groups (treatment group and control group). Patients in treatment group were treated with electro-acupuncture, while patients in control group were treated with paroxetine hydrochloride. Both of the two groups consisted of four-week sessions. Outcome measures which include the scores of HAMA, SDS CGI-EI of all participants were collected at similar time points (baseline,1week,2weeks and4weeks post intervention) to evaluate the onset and short-term effects. The score of spiritual anxiety factor, somatic anxiety factor and sleep factor of the Hamilton anxiety scale (HAMA) were also measured. Self-care ability assessment Barthel index (BI) is used to evaluate the improvement of physical rehabilitation. At the same time, the safety of two treatments was also evaluated with Treatment emergent symptom scale (TESS). Follow-up was carried out at3months and6months after the last treatment.
Results
Between May2010and February2012,672cases were checked while140patients met the entry criteria for the study and were invited to participate. They were randomized into treatment group (n=70) or control group (n=70). There was no significant difference between the two groups on demographic and clinical characteristics which mean baselines were equal.
Clinical effective rate was evaluated according to the decreasing score rate of HAMA. It was84.7%in Treatment group while was82.9%in medicine group. There was no significant difference between the two groups after the rates being statistic analyzed.
Both HAMA and SAS scores showed significant difference before and after treatment in both groups (P<0.05). However there was no statistical difference between the two groups which mean they have equal effect (P>0.05). The scale scores of three factors in HAMA (spiritual anxiety factor, somatic anxiety factor, sleep factor) decreased obviously after treatment and showed significant statistical difference in both groups. Furthermore the final result showed significant difference between the two groups in somatic factors' score (P<0.05) while show no difference in other two factors'(P>0.05). The score of CGI showed significant difference between both groups (P<0.05).
Both HAMA and SAS scores showed significant difference between before and after2-weeks'treatment in both groups (P<0.05). And there was significant statistical difference between the two groups which mean treatment group took effect earlier than the other. The somatic anxiety factors' score in treatment group showed significant difference after1-week's treatment while it didn't in control group. It indicated that Treatment group took effect much earlier than the other on somatic anxiety factor. The scale scores of two factors in HAMA (spiritual anxiety factor, sleep factor) also decreased obviously after2weeks treatment and showed significant statistical difference in both groups. Furthermore the final result showed significant difference between the two groups in spiritual anxiety factor while show no difference in the other.
The score of BI showed significant difference before and after treatment in both groups (P<0.05). However there was no statistical difference between the two groups which mean they have equal effect (P>0.05).
3months and6months later, compared to the last treatment the score of HAMA showed no significant statistical difference(P>0.05). It indicated that the effect remained.
Safety evaluation showed that two cases had slight dizziness in Treatment group during treatment period. But in medicine group,16cases suffered from medical side effect.
Conclusion
Both electro-acupuncture and western medicine could provide satisfactory outcome of post-stroke anxiety disorders, and there were no significant difference in both short-term and middle-term effects between them. Acupuncture treatment took effect earlier than west medicine. Furthermore, acupuncture treatment showed superiority in somatic anxiety relief over Paroxetine. And acupuncture was well-tolerated.
中风是指现代西医学中的脑血管病,中风的发病率、复发率、致残率及致死率都很高,占我国人口死因的第二位。中风后焦虑障碍是脑血管病常见的长期并发症,国内外流行病学研究显示其发病率为20-40%。该病是一种常见和持久的痛苦,尤其是中度以上的中风后焦虑,直接干扰中风患者的生活质量和躯体、认知功能恢复,甚至可引起再发。因此,及早关注及治疗中风后焦虑将有利于提高生活质量及改善功能恢复,并降低致残率及死亡率。近10年来,中风后情绪障碍成为专科医生研究的热点,中风后抑郁障碍的临床研究相对较为成熟,中风后焦虑障碍的研究较少,也较不完善。国外的研究多集中在西药的疗效、不良反应的对比研究,以及对躯体功能恢复干预方面的研究。由于西药的副作用大,起效慢,需长期服用,撤药困难,价格较贵,依从性差等多方面原因,使得患者多数不愿接受规范的西药抗焦虑治疗,往往贻误病情。因此寻找一种疗效确切,安全易接受的治疗手段势在必行。
相对于西药而言,针刺治疗立足于整体脏腑调节,即可调节情绪,又可改善情绪导致的躯体症状,且躯体症状的改善有可能先于情绪症状,而西药治疗恰恰相反,一定是通过改善情绪继而改善由此引起的躯体症状。并且针刺还具有简便易行、无依赖、安全易接受等特点。不同于由东方病耻感引起的对药物的抵触心理,多数焦虑患者对针刺易于接受,尤其是中风后患者。通过近10年的文献复习发现目前多数研究存在样本量偏小,观察项目有限,未规范随机等问题。未见到针药对比的起效时间及随访研究。
目的
本研究旨在通过严格的随机对照研究,对电针焦虑方治疗焦虑的近期疗效,起效时间、随访及安全性进行评价。
方法
所有病人均来源于中国中医科学院广安门医院针灸科病房2010年10月—2012年2月的住院中风患者,共筛选患者672例,符合入选标准140例,进行随机分入焦虑穴方组70例,药物组70例。焦虑穴方组取穴为：百会、印堂、四神聪、太阳、内关、神门。于双太阳穴,百会及印堂穴针柄连接G6805治疗仪两电极,高频100HZ,连续波形,电流幅度以患者能忍受为度。每日一次,每次30分钟,每周五次,疗程共四周。药物组：规范化口服SSRI盐酸帕罗西汀片,10mgQD,4天后服20mg QD。疗程共四周。两组的基础治疗一致,西药治疗均采用脑血管病的规范治疗,基础础针灸治疗以改善肢体功能为主,不取头部穴位及神门、内关穴。
在治疗第一、二、四周应用汉密尔顿焦虑量表(HAMA)、Zung氏焦虑自评量表(SAS)评价中风后焦虑的近期疗效、起效时间,同时应用汉密尔顿焦虑量表(HAMA)评分中三因子评分来细化评估焦虑穴方组的优势所在。在第四周末用临床疗效总评量表-疗效指数(CGI-EI)评价两组的疗效指数,应用生活自理能力评定Barthel指数(BI)评估两组治疗前后患者躯体功能恢复情况。在治疗后3个月、6个月时以电话随访的方式用汉密尔顿焦虑量表(HAMA)进行中期疗效评估。对入组患者性别、年龄、婚况、病程、陪护人员、家庭经济状况、患者文化程度等方面进行焦虑的严重程度的相关性对比。
结果
1.近期疗效
总共纳入140例患者,其中焦虑穴方组70例,脱落2例；药物组70例,脱落7例。故最终完成观察焦虑穴方组68例,药物组63例。
焦虑穴方组与药物组在性别、年龄、病程、病情轻重等方面对比无统计学差异(P>0.05),基线一致,具可比性。
焦虑穴方组总有效率为84.3%,药物组总有效率为82.9%,两组对比疗效相当(P>0.05)。焦虑穴方组治疗前后HAMA评分明显下降,经配对t检验,具有极显著性差异(P<0.001),说明电针对于改善焦虑方面疗效肯定。药物组治疗前后HAMA评分明显下降,具有统计学差异(P<0.05),两组治疗后对比,经独立样本t检验,无显著差异(P>0.05),表明两组疗效相当。
HAMA中包含精神性焦虑、躯体性焦虑、睡眠因子等三个因子,可以通过两组对三个因子的影响程度来明确电针焦虑方在治疗焦虑方面的优势所在。精神性焦虑因子、睡眠因子方面焦虑穴方组与药物组治疗前后均有显著性差异(P<0.05),但两组间在治疗后无显著性差异(P>O.05),说明疗效相当。躯体性焦虑因子两组治疗前后均有极显著性差异(P<0.01),疗后呈显著性差异(P<0.05),说明焦虑穴方组在治疗躯体性焦虑方面较药物有一定优势。
Zung氏焦虑自评量表(SAS)是患者自评量表,旨在从患者角度评估疗效。焦虑穴方组及药物组治疗前后SAS评分均明显下降,具有显著性差异(P<0.05),西组治疗后对比,无显著差异(P>0.05),表明两组疗效相当。
临床疗效总评量表疗效指数(Clinical Global Impression. CGI-EI)两组对比有显著统计学差异(P<0.05),提示焦虑穴方组在疗效指数方面有优势。
BI评分反映了中风患者躯体功能恢复的程度,两组治疗前后BI评分均有显著提高,具备显著性差异(P<0.05),但两组间疗后对比不具显著性差异(P>0.05),说明两组对患者的躯体功能恢复改善程度相当。对焦虑穴方组及药物组BI评分的提高与HAMA减分率的相关性进行研究,发现两组均有相关性,具显著性差异(P<0.05),提示BI评分提高者焦虑疗效好。
2.起效时间研究
焦虑穴方组与药物组治疗2周后,两组HAMA评分较之疗前均有显著性差异(P<0.05),焦虑穴方组评分下降显著,与药物组比较有显著性差异(P<0.05),提示焦虑穴方组起效快。
焦虑穴方组与药物组治疗2周后,两组SAS评分较之疗前均有极显著性差异(P≤0.01),焦虑穴方组评分下降显著,与药物组比较有极显著性差异(P≤0.01),提示焦虑穴方组起效快。
焦虑穴方组与药物组治疗1周后,躯体性焦虑因子焦虑穴方组较疗前即呈现显著性差异(P<0.05),2周时呈极显著差异(P<0.01)且与药物组对比有统计学差异(P<0.05),提示焦虑穴方组在改善躯体焦虑方面1周即起效,较药物组有优势。在精神性焦虑因子方面两组均于2周时较疗前评分出现显著性差异(P<0.05),且焦虑穴方组下降明显,组间对比呈显著性差异(P<0.05)提示焦虑穴方组起效快。在睡眠因子方面两组均于两周起效(P<0.05),且疗效相当(P>0.05)
3.治疗后3个月及6个月的随访研究
随访病例焦虑穴方组脱落8例,药物组脱落10例。其中14例为联系方式有误,另焦虑穴方组及药物组分别有2例拒绝受访。故最终完成观察焦虑穴方组60例,药物组53例纳入统计。
焦虑穴方组与药物组在3个月和6个月的HAMA评分分别与治疗前相比仍具统计学差异(P<0.05),而与治疗1个月相比无统计学意义(P>0.05),表明两组患者在半年内焦虑疗效仍就维持。两组患者在3个月及6个月的HAMA评分的组间对比不具有统计学差异(P>0.05),表明两组患者在半年内的焦虑疗效相当。
4.焦虑症状的相关因索分析
中风后焦虑的相关因素分析显示,女性、年龄大于55岁、离异/丧偶者,家庭人均收入低、文化程度高者焦虑程度较高(P<0.05)。而病程、陪护等因素与焦虑病情程度无相关(P>0.05)。
5.安全性评价
采用TESS评定副反应,结果在研究过程中,药物组共有16例出现副反应(其中9例同时出现两种不良反应),占西药组总人数的25.39%,口干出现9例,恶心出现3例,便秘出现6例,头晕出现6例,嗜睡出现1例,实验室检查均未见异常。针刺组仅2例出现不良反应,占治疗组总人数的2.94%,头晕2例,均在休息后自行缓解,未出现滞针、断针、感染等不良反应记录。
结论
电针焦虑方治疗中风后焦虑与药物组近期疗效及中期疗效相当,起效较药物组早,在改善躯体性焦虑方面在疗效和起效时间上均较药物有优势。两组在改善躯体功能障碍方面也疗效相当。焦虑穴方组安全性好于药物组。
Background
Stroke is a one of the most common cause of disability and can have a profound impact on a person's physical, emotional, and social functioning and wellbeing. Following a stroke, individuals can experience a loss in functional ability, barriers to community integration, increases in idle time, social isolation, depression, anxiety, financial and vocational changes, and lower feelings of personal autonomy. Because of that, emotional disorders after stroke become very important. It is a common long-term complication of cerebral vascular disease. Foreign and domestic epidemiological study show that incidences of anxiety disorder in post-stroke patients is from20%to40%. Studies indicated that post-stroke anxiety is the most common psychiatric disorder in stroke complication which will seriously influence the physical rehabilitation. Now the conventional treatment includes medication and psychological treatment. Treatment with benzodiazepines and newer antidepressants is often inadequate because of their limited clinical efficacy and side effects. Psychological treatment is limited due to slow working, uncertain efficacy and time consuming etc. In recent years, more and more researchers start to look for new treatments which have better clinical effect, safe and well-tolerated. Acupuncture treatment may be one of the hot spot for its rapid onset of action, equivalent efficacy and safety. To further investigate the effect of acupuncture treatment which include short and medium term effects on post-stroke anxiety, this study aims to demonstrate through a RCT whether acupuncture produces equivalent result to the result of first-lined antidepressant.
Research objectives
The primary research objective was to observe the clinical effect of electro-acupuncture (EA) treatment on post-stroke anxiety disorder when compared to control group using Paroxetine. The clinical observation included onset time, short-term effect and follow-up. The other objectives were to identify the specific advantage of electro-acupuncture (EA) treatment and to evaluate the safety of both therapies. To evaluate the
Methods
140PSAD patients were randomized into two groups (treatment group and control group). Patients in treatment group were treated with electro-acupuncture, while patients in control group were treated with paroxetine hydrochloride. Both of the two groups consisted of four-week sessions. Outcome measures which include the scores of HAMA, SDS CGI-EI of all participants were collected at similar time points (baseline,1week,2weeks and4weeks post intervention) to evaluate the onset and short-term effects. The score of spiritual anxiety factor, somatic anxiety factor and sleep factor of the Hamilton anxiety scale (HAMA) were also measured. Self-care ability assessment Barthel index (BI) is used to evaluate the improvement of physical rehabilitation. At the same time, the safety of two treatments was also evaluated with Treatment emergent symptom scale (TESS). Follow-up was carried out at3months and6months after the last treatment.
Results
Between May2010and February2012,672cases were checked while140patients met the entry criteria for the study and were invited to participate. They were randomized into treatment group (n=70) or control group (n=70). There was no significant difference between the two groups on demographic and clinical characteristics which mean baselines were equal.
Clinical effective rate was evaluated according to the decreasing score rate of HAMA. It was84.7%in Treatment group while was82.9%in medicine group. There was no significant difference between the two groups after the rates being statistic analyzed.
Both HAMA and SAS scores showed significant difference before and after treatment in both groups (P<0.05). However there was no statistical difference between the two groups which mean they have equal effect (P>0.05). The scale scores of three factors in HAMA (spiritual anxiety factor, somatic anxiety factor, sleep factor) decreased obviously after treatment and showed significant statistical difference in both groups. Furthermore the final result showed significant difference between the two groups in somatic factors' score (P<0.05) while show no difference in other two factors'(P>0.05). The score of CGI showed significant difference between both groups (P<0.05).
Both HAMA and SAS scores showed significant difference between before and after2-weeks'treatment in both groups (P<0.05). And there was significant statistical difference between the two groups which mean treatment group took effect earlier than the other. The somatic anxiety factors' score in treatment group showed significant difference after1-week's treatment while it didn't in control group. It indicated that Treatment group took effect much earlier than the other on somatic anxiety factor. The scale scores of two factors in HAMA (spiritual anxiety factor, sleep factor) also decreased obviously after2weeks treatment and showed significant statistical difference in both groups. Furthermore the final result showed significant difference between the two groups in spiritual anxiety factor while show no difference in the other.
The score of BI showed significant difference before and after treatment in both groups (P<0.05). However there was no statistical difference between the two groups which mean they have equal effect (P>0.05).
3months and6months later, compared to the last treatment the score of HAMA showed no significant statistical difference(P>0.05). It indicated that the effect remained.
Safety evaluation showed that two cases had slight dizziness in Treatment group during treatment period. But in medicine group,16cases suffered from medical side effect.
Conclusion
Both electro-acupuncture and western medicine could provide satisfactory outcome of post-stroke anxiety disorders, and there were no significant difference in both short-term and middle-term effects between them. Acupuncture treatment took effect earlier than west medicine. Furthermore, acupuncture treatment showed superiority in somatic anxiety relief over Paroxetine. And acupuncture was well-tolerated.
引文
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