关键词: 抑郁, 卒中, 肝郁脾虚, 五行, 音乐疗法, 针刺, 胃肠道微生物组, 血清素

Abstract: Background　Wuyintiaoshen therapy（acupuncture combined with five-element music therapy）has proven to be effective in treating post-stroke depression（PSD），but there is a lack of studies on its clinical response and mechanism of action in PSD patients with liver qi stagnation and spleen deficiency syndrome. Objective　To investigate the clinical，gut flora，and serum serotonin responses to Wuyintiaoshen therapy in mild-to-moderate PSD patients with liver qi stagnation and spleen deficiency syndrome. Methods　Seventy-two mild-to-moderate PSD outpatients and inpatients with liver qi stagnation and spleen deficiency syndrome were recruited from the Rehabilitation Clinic and Ward of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine，and equally randomized into control group（routine medical treatment with escitalopram）and experimental group（routine medical treatment with Wuyintiaoshen therapy）. Clinical response，pre- and post-treatment mean Hamilton Rating Scale for Depression（HAMD-17）scores，Gastrointestinal Symptom Rating Scale（GSRS）scores，number of strains of gut floras and serum serotonin levels were compared between the two groups. Results　After treatment，the experimental group had better clinical response，lower mean HAMD-17 and GSRS scores，higher mean number of strains of Bifidobacterium and Lactobacillus，lower mean number of strains of Escherichia coli and Enterococcus，and higher mean serum serotonin level than the control group（P<0.01）. Conclusion　Wuyintiaoshen therapy could effectively reduce the depression level，alleviate gastrointestinal symptoms，and regulate gut flora and serum serotonin level，indicating that the therapy could improve both physical and mental conditions in mild-to-moderate PSD patients with liver qi stagnation and spleen deficiency syndrome.

Key words: Depression, Stroke, Liver qi stagnation and spleen deficiency, Five-elements, Music therapy, Acupuncture, Gastrointestinal microbiome, Serotonin