针刺治疗中风后抑郁:随机对照试验的研究

注册号:

Registration number:

ITMCTR2025000806

最近更新日期:

Date of Last Refreshed on:

2025-04-22

注册时间:

Date of Registration:

2025-04-22

注册号状态:

Registration Status:

预注册

Prospective registration

注册题目:

针刺治疗中风后抑郁:随机对照试验的研究

Public title:

Acupuncture for the Post-Stroke depression: a study of a randomized controlled trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

针刺治疗中风后抑郁:随机对照试验的研究

Scientific title:

Acupuncture for the Post-Stroke depression: a study of a randomized controlled trial

研究课题的正式科学名称简写:

Scientific title acronym:

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

张洁雯

研究负责人:

崔韶阳

Applicant:

Jiewen Zhang

Study leader:

Shaoyang Cui

申请注册联系人电话:

Applicant telephone:

15302750289

研究负责人电话:

Study leader's telephone:

15112491899

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

Zhjw_acu2290@163.com

研究负责人电子邮件:

Study leader's E-mail:

herb107@126.com

申请单位网址(自愿提供):

Study leader's website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website
(voluntary supply):

申请注册联系人通讯地址:

深圳市福田区北环大道6001号广州中医药大学深圳医院

研究负责人通讯地址:

深圳市福田区北环大道6001号广州中医药大学深圳医院

Applicant address:

Shenzhen Hospital of Guangzhou University of Traditional Chinese Medicine No. 6001 Beihuan Avenue Futian District Shenzhen China

Study leader's address:

Shenzhen Hospital of Guangzhou University of Traditional Chinese Medicine No. 6001 Beihuan Avenue Futian District Shenzhen China

申请注册联系人邮政编码:

Applicant postcode:

518000

研究负责人邮政编码:

Study leader's postcode:

518000

申请人所在单位:

广州中医药大学深圳医院(福田)

Applicant's institution:

Shenzhen Hospital (Fu Tian) of Guangzhou University of Chinese Medicine

是否获伦理委员会批准:

Approved by ethic committee:

伦理委员会批件文号:

Approved No. of ethic committee:

GZYLL(KY)-2025-009

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件

批准本研究的伦理委员会名称:

广州中医药大学深圳医院(福田)医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of Guangzhou University of Traditional Chinese Medicine Shenzhen Hospital (Futian)

伦理委员会批准日期:

Date of approved by ethic committee:

2025/1/15 0:00:00

伦理委员会联系人:

卢琳

Contact Name of the ethic committee:

Lin Lu

伦理委员会联系地址:

深圳市福田区北环大道6001号广州中医药大学深圳医院

Contact Address of the ethic committee:

Shenzhen Hospital (Fu Tian) of Guangzhou University of Chinese Medicine

伦理委员会联系人电话:

Contact phone of the ethic committee:

0755-83548506

伦理委员会联系人邮箱:

Contact email of the ethic committee:

gzyszyyll@126.com

研究实施负责(组长)单位:

广州中医药大学深圳医院(福田)

Primary sponsor:

Shenzhen Hospital (Fu Tian) of Guangzhou University of Chinese Medicine

研究实施负责(组长)单位地址:

深圳市福田区北环大道6001号广州中医药大学深圳医院

Primary sponsor's address:

Shenzhen Hospital of Guangzhou University of Traditional Chinese Medicine No. 6001 Beihuan Avenue Futian District Shenzhen China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

广东省

市(区县):

深圳市

Country:

China

Province:

Guangdong

City:

Shenzhen

单位(医院):

广州中医药大学深圳医院(福田)

具体地址:

深圳市福田区北环大道6001号广州中医药大学深圳医院

Institution
hospital:

Shenzhen Hospital (Fu Tian) of Guangzhou University of Chinese Medicine

Address:

Shenzhen Hospital of Guangzhou University of Traditional Chinese Medicine No. 6001 Beihuan Avenue Futian District Shenzhen China

经费或物资来源:

广州中医药大学深圳医院(福田)

Source(s) of funding:

Shenzhen Hospital (Fu Tian) of Guangzhou University of Chinese Medicine

研究疾病:

中风后抑郁

研究疾病代码:

Target disease:

Post-Stroke depression

Target disease code:

研究类型:

Study type:

干预性研究

Interventional study

研究设计:

Study design:

随机平行对照

randomized controlled trial(parallel group design)

研究所处阶段:

Study phase:

探索性研究/预试验

Pilot clinical trial

研究目的:

采用单中心、主要研究者及受试者盲法、前瞻性、优效性的RCT以及在基于证据随机对照临床试验前提上运用具有高空间、时间分辨率的神经多模态成像技术—静息态功能性磁共振扫描包括 3D-T1、T2-Flair、Bold 的多层次序列,分别在治疗前、后进行两次扫描,初步阐释mPFC脑区在针刺治疗中风后抑郁中的效应机制。

Objectives of Study:

A single-center principal investigator- and subject-blinded prospective superiority RCT and a multilevel sequence of neural multimodal imaging with high spatial and temporal resolution-resting-state functional magnetic resonance (rs-fMRI) scans including 3D-T1 T2-Flair and Bold were used on the premise of the evidence-based RCT respectively. Two scans were performed before and after treatment to preliminarily elucidate the effect mechanism of mPFC brain region in acupuncture treatment of post-stroke depression (PSD).

药物成份或治疗方案详述:

Description for medicine or protocol of treatment in detail:

纳入标准:

(1)符合缺血性脑卒中符合国际疾病分类第十一版(ICD-11)中的定义,且抑郁表现符合《精神障碍诊断与统计手册》第五版(DSM-5)中抑郁的诊断标准的患者群体; (2)神经影像学显示首次发生缺血性脑卒中,病程处于 1-6 月(恢复期); (3)经过爱丁堡利手量表(EHI)评估为右利手; (4)年龄大于18岁且小于80岁; (5)汉密顿抑郁量表评分(HAMD-17)≥8分; (6)未服用过任何与治疗抑郁相关药物/服用剂量稳定的抑郁药物; (7)意识清楚,无明显沟通障碍,生命体征平稳(以美国国立卒中量表 NIHSS 中 意识水平及语言项目进行判定); (7)既往6个月未接受过针灸治疗。

Inclusion criteria

(1) A group of patients who met the definition of ischemic stroke as defined in the International Classification of Diseases Eleventh Edition (ICD-11) and whose depressive manifestations met the diagnostic criteria for depression in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5); (2) Neuroimaging showing a first ischemic stroke with a disease duration of 1-6 months (recovery period); (3) Right-handedness as assessed by the Edinburgh Handedness Inventory (EHI); (4) Age greater than 18 years and less than 80 years; (5) Hamilton Depression Scale score (HAMD-17) ≥ 8; (6) Not taking any medication related to the treatment of depression/taking a stable dose of depression medication; (7) Consciousness no significant communication difficulties and stable vital signs (as determined by the level of consciousness and language items of the National Instrument for Stroke Scale (NIHSS)); (7) Have not received acupuncture treatment in the previous 6 months.

排除标准:

(1)脑卒中前即存在精神障碍病史、药物滥用史、成瘾史; (2)针灸禁忌症,如针刺部位的溃疡、脓肿、皮肤感染等; (3)合并有严重循环系统、呼吸系统、消化系统、泌尿系统、内分泌系统和造血 系统等原发性疾病且常规用药无法控制的患者; (4)试验期间计划进行手术的患者; (5)幽闭恐惧症或符合功能性磁共振其他禁忌症; (6)近一个月内参加过其他临床医学试验研究; (7)无法给予知情同意; (8)孕妇或哺乳期女性。

Exclusion criteria:

(1) History of mental disorders drug abuse and addiction immediately prior to stroke; (2) Contraindications to acupuncture such as ulcers abscesses and skin infections at the site of needling; and (3) Patients with severe primary diseases of the circulatory system respiratory system digestive system urinary system endocrine system and hematopoietic system which cannot be controlled by conventional medication; (4) Planned surgery during the trial period. (4) Patients who are scheduled to undergo surgery during the trial; (5) Patients who are claustrophobic or in compliance with the trial. (5) Claustrophobia or other contraindications to functional magnetic resonance; and (6) Participation in other clinical trials within the last month; (7) Inability to give informed consent. (7) Inability to give informed consent; and (8) Pregnant or lactating women.

研究实施时间:

Study execute time:

From 2025-05-20

To      2027-01-31

征募观察对象时间:

Recruiting time:

From 2025-05-20

To      2027-01-31

干预措施:

Interventions:

组别:

针刺干预组

样本量:

59

Group:

Acupuncture treatment group

Sample size:

干预措施:

针刺

干预措施代码:

Intervention:

Acupuncture

Intervention code:

组别:

假针刺对照组

样本量:

59

Group:

Sham acupuncture control group

Sample size:

干预措施:

假针刺

干预措施代码:

Intervention:

Sham acupuncture

Intervention code:

样本总量 Total sample size : 118

研究实施地点:

Countries of recruitment
and research settings:

国家:

中国

省(直辖市):

广东省

市(区县):

深圳市

Country:

China

Province:

Guangdong

City:

Shenzhen

单位(医院):

广州中医药大学深圳医院(福田)

单位级别:

三甲医院

Institution/hospital:

Shenzhen Hospital (Fu Tian) of Guangzhou University of Chinese Medicine

Level of the institution:

Third-class hospital

测量指标:

Outcomes:

指标中文名:

抑郁症筛查量表

指标类型:

主要指标

Outcome:

Patient Health Questionnaire - 9 Item Version

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

广泛性焦虑障碍量表

指标类型:

次要指标

Outcome:

Generalized Anxiety Disorder(GAD-7)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

毛氏针刺期望效应评估量表

指标类型:

次要指标

Outcome:

Mao Treatment Expectancy Scale

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

脑卒中专用生活质量量表

指标类型:

次要指标

Outcome:

Stroke specific Quality of Life Scale

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

脑卒中康复自我效能量表

指标类型:

次要指标

Outcome:

Stroke Rehabilitation Self Efficacy Scale

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

广泛性焦虑障碍量表

指标类型:

次要指标

Outcome:

Generalized Anxiety Disorder Scale-7

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

改良Rankin量表

指标类型:

次要指标

Outcome:

Improved Rankin Scale

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

汉密尔顿17项

指标类型:

主要指标

Outcome:

Hamilton Depression Scale-17 item

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

静息态功能性磁共振

指标类型:

附加指标

Outcome:

Resting-state functional magnetic resonance

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

美国国立卫生研究院卒中量表

指标类型:

次要指标

Outcome:

national institute of health stroke scale

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

blood   血液 外周血 血液

Tissue:

人体标本去向

使用后销毁

说明

代谢组学

Fate of sample 

Destruction after use

Note:

征募研究对象情况:

尚未开始

Not yet recruiting

年龄范围:

最小 18
Min age years
最大 80
Max age years

Recruiting status:

Participant age:

性别:

Gender:

男女均可

Both

随机方法(请说明由何人用什么方法产生随机序列):

随机化系统使用由广州中医药大学深圳医院康复科及深圳市“三名工程”中医肿瘤康复平台自行研发中央随机化系统,采用分层区组方法。随机分配系统具体执行及操作由与广州中医药大学华南针灸中心的人员完成(随机化人员与本次试验其他部分无关),当研究者确认合格病例之后,向中央随机系统提出申请,中央随机系统根据随机化方法自动分配组别信息,并将组别信息发送给研究者及针灸师,向不同组别的受试者分配干预措施。分配序列的隐藏:所有的分配信息在受试者纳入前是不可预测且不可见的,分配序列由直接由系统发送通知针灸师确保了分配序列的隐藏和随机化过程的公平性。负责进行疗效评价的人员为第三方人员,主要研究者不会知晓患者的分组情况。对数据统计的数据库设立一级盲底,统计师不知晓具体的组别情况。

Randomization Procedure (please state who generates the random number sequence and by what method):

The randomization system was developed by the Rehabilitation Department of Guangzhou University of Chinese Medicine Shenzhen Hospital and the Shenzhen "Three Project" Traditional Chinese Medicine Tumor Rehabilitation Platform using a stratified block method. The specific implementation and operation of the randomization system were completed by the personnel from the South China acupuncture and moxibustion Center of Guangzhou University of Traditional Chinese Medicine (the randomization personnel had nothing to do with other parts of the trial). When the researchers confirmed the qualified cases they submitted an application to the central randomization system which automatically allocated group information according to the randomization method and sent the group information to the researchers and acupuncture and moxibustion to assign intervention measures to subjects in different groups. Hiding of allocation sequence: all allocation information is unpredictable and invisible before the subjects are included. The allocation sequence is sent directly by the system to inform the acupuncture and moxibustion to ensure the hiding of allocation sequence and fairness of randomization process. The personnel responsible for conducting efficacy evaluation are third-party personnel and the main researchers will not be aware of the patient grouping. Establish a first level blind background for the database of data statistics and statisticians are unaware of the specific group situation.

盲法:

本研究采用主要研究者盲法,即研究设计者、受试者、结局评估者和统计分析者对分组情况不知情,针灸师不设盲。针刺盲法辅助装置采用广州中医药大学附属第一医院的装置且已在多项研究被证明有效。该装置已获得国家知识产权局专利(授权号:202121352221.7)。该针刺盲法辅助装置由底座、导管、粘胶贴构成。底座由树脂材料制成,不透明,可以阻挡受试者的视线,使受试者无法从视觉上辨别针是否已经穿透皮肤。底座内部中空,表面则配有三个孔,一个在顶部,为直刺孔,用于直刺;两个在侧面,一个位置略高,为斜刺孔,用于斜刺;一个位置略低,为平刺孔,用于平刺。底座的底部装有3M牌粘胶贴,用于确保底座能牢牢的固定在穴位处的皮肤上。粘胶贴表面覆盖有一层塑料膜,在使用时可揭下露出粘胶贴。导管则由透明塑料制成,便于针灸医师通过导管插入毫针。该针刺盲法辅助装置有两种类型:A型和B型。两种类型的底座装置形状相同,但A型针刺盲法辅助装置底部是中空的粘胶贴,允许毫针直接地插入皮肤,用于真针刺。B型的底部则是实心的粘胶贴,使用一次性钝头针无法刺破表皮。实心粘胶贴能将假针牢牢固定在适当位置,防止其上下移动。

Blinding:

This study was conducted with principal investigator blinding i.e. the study designer subjects outcome assessors and statistical analysts were unaware of the subgroups and the acupuncturists were not blinded.The acupuncture blinding aid was a device from the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine that has been shown to be effective in several studies.The device has been patented by the State Intellectual Property Office (Grant No. 202121352221.7).The acupuncture blindness assisting device consists of a base a catheter and an adhesive sticker.The base is made of a resin material that is opaque and blocks the subject's vision so that the subject cannot visually discern whether the needle has penetrated the skin.The interior of the base is hollow and the surface is equipped with three holes one at the top for straight stabbing holes for straight stabbing; two on the side one position is slightly higher for oblique stabbing holes for oblique stabbing; one position is slightly lower for flat stabbing holes for flat stabbing.The bottom of the base is equipped with a 3M adhesive sticker to ensure that the base can be firmly fixed on the skin at the acupuncture points.The adhesive tape is covered with a plastic film that can be removed to reveal the adhesive tape during use.The catheter is made of transparent plastic making it easy for the acupuncturist to insert the needle through the catheter.There are two types of these blind needling aids: Type A and Type B. The base unit is identical in shape to the base unit.Both types have the same shape but Type A has a hollow adhesive base that allows the needles to be inserted directly into the skin for true needling while Type B has a solid adhesive base that does not allow disposable blunt-tipped needles to pierce the epidermis.The solid adhesive patch holds the dummy needle firmly in place and prevents it from moving up or down.

是否共享原始数据:

IPD sharing:

Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

联系研究负责人

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Contact the Head of Research

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC)。本研究所有数据保存均由广州中医药大学深圳医院康复科联合白塔数据构建专病数据库中电子CRF模块进行保存,所有产生的数据将由两名独立数据录入员进行录入(见图10)。在数据录入正式开始前,对数据录入员进行SOP专门的培训。当数据录入完毕后,将由专门的数据检查人员对数据进行逐一核查,将不正确的数据进行重新录入。 此外,本临床研究所收集纸质的知情同意书、所有受试者的CRF表,及其他相关数据档均存纸质资料妥善保存在广州中医药深圳医院康复科GCP档案室中。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Data collection and management consists of two parts Case Record Form (CRF) and Electronic Data Capture (EDC).All the data saved in this study were saved by the Department of Rehabilitation of Guangzhou University of Traditional Chinese Medicine Shenzhen Hospital in conjunction with White Tower Data to construct the electronic CRF module in the specialized disease database and all the data generated will be entered by two independent data entry clerks (see Figure 10).Before the official start of data entry the data entry clerks will be specifically trained in SOP.When data entry is complete the data will be checked individually by specialized data checkers and incorrect data will be re-entered. In addition paper informed consent forms CRF forms of all subjects and other related data files were collected and stored in paper form in the GCP archive room of the Department of Rehabilitation Guangzhou Hospital of Traditional Chinese Medicine Shenzhen China.

数据管理委员会:

Data Managemen Committee:

Yes

研究计划书或研究结果报告发表信息
(杂志名称、期、卷、页,时间;或网址):

Publication information of the protocol/research results report
(name of the journal, volume, issue, pages, time; or website):

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