目的：观察“颅底七穴”针刺治疗脑梗死后抑郁症肝郁气滞型患者的作用机制。方法：选取脑梗死后抑郁症肝郁气滞型患者130例，随机分为对照组和观察组各65例。对照组采用西医常规治疗，观察组联合“颅底七穴”针刺治疗，治疗周期为4周。比较两组治疗前后匹兹堡睡眠质量指数（PSQI）、汉密尔顿焦虑量表（HAMD）评分、中医症状总积分改善情况；比较两组治疗前后血清白细胞介素-6(IL-6)、同型半胱胺酸（Hcy）、5-羟色胺（5-HT）、胃泌素（GAS）、脑源性神经生长因子（BDNF）、脑血流改善情况及两组总有效率差异。结果：治疗后两组PSQI评分、HAMD评分、中医症状总积分降低（P<0.05）；组间比较显示，治疗后观察组上述评分均更低（P<0.05）；治疗后两组血清IL-6、Hcy降低，5-HT、GAS、BDNF升高；治疗后观察组血清IL-6、Hcy低于对照组，5-HT、GAS、BDNF高于对照组，差异具有统计学意义（P<0.05）；治疗后，两组基底动脉、椎动脉收缩期流速峰值均升高（P<0.05），且观察组较对照组改善更明显（P<0.05）；观察组总有效率96.92%，高于对照组（83.08%）(P<0.05)。结论：脑梗死后抑郁症肝郁气滞型患者针刺“颅底七穴”治疗有助于减轻炎症反应，调控神经因子，改善脑部血流，从而提高临床疗效。

Objective:To explore the mechanism of acupuncture at the “seven points on the base of the skull” in the treatment of patients with poststroke depression of liver qi stagnation type. Methods:Totally 130 patients with poststroke depression of liver qi stagnation type were included and randomly divided into control group and observation group,65 patients in each group. The control group received routine western medicine treatment,while the observation group received acupuncture treatment at the “seven acupoints at the base of the skull” and western medicine treatment. The therapeutic effect was compared after 4 weeks of treatment. Improvements of Pittsburgh Sleep Quality Index(PSQI),Hamilton Anxiety Scale(HAMD) scores,and total score of traditional Chinese medicine symptoms were compared between two groups before and after treatment. And improvements of serum interleukin-6(IL-6),homocysteine(Hcy),serotonin(5-HT),gastrin(GAS),brain-derived neurotrophic factor(BDNF),and cerebral blood flow before and after treatment between two groups. The difference in total effective rate between the two groups was compared,too.Results:After treatment,the serum levels of IL-6 and Hcy in the observation group were lower than those in the control group,while levels of 5-HT,GAS,and BDNF were higher,with statistical difference(P<0.05);After treatment,the observation group showed lower PSQI score,Hamilton Anxiety Scale(HAMD) score,and traditional Chinese medicine total symptom score(P<0.05);after treatment,the peak systolic flow velocity of the basilar artery and vertebral artery in both groups increased(P<0.05),and the improvement in the observation group was more significant than that in the control group(P<0.05);the total effective rate of the observation group was 96.92%(63/65),higher than that of the control group(83.08%)(P<0.05).Conclusion:For patients with post-stroke depression of liver qi stagnation type,the combination of “seven acupoints at the base of the skull” acupuncture treatment can alleviate inflammatory reactions,regulate nerve factors,improve cerebral blood flow,and enhance clinical efficacy.