Objective To explore the efficacy of acupuncture combined with Shugan Huoxue Decoction for the treatment of patients with post⁃stroke depression and its effect on patients' peripheral and central neurotransmitters. Methods A total of 76 patients with post⁃stroke depression were randomly assigned to Western Medicine group or Traditional Chinese Medicine group, with 38 cases in each group. The Western Medicine group received basic treatment plus Western Medicine (citalopram), based on which the Traditional Chinese Medicine group additionally received acupuncture combined with Shugan Huoxue Decoction for treatment. Both groups adopted 2⁃month treatment. The pre⁃ and post⁃treatment Hamilton Depression Scale (HAMD) score, National Institutes of Health Stroke Scale (NIHSS) score, and Stroke Specific Quality of Life (SS⁃QOL) scale score, as well as pre⁃ and post⁃treatment levels of peripheral plasma 5⁃hydroxytryptamine (5⁃HT), norepinephrine (NE), dopamine (DA), γ⁃aminobutyric acid (GABA), and glutamate (Glu) were compared between the two groups. Magnetic resonance spectroscopy was adopted to detect pre⁃ and post⁃treatment contents of N⁃acetyl⁃aspartate (NAA), choline (Cho), myo⁃inositol (MI), and creatine (Cr) in bilateral frontal lobes and hippocampus of both groups, and values of NAA/Cr, MI/Cr, and Cho/Cr in bilateral frontal lobes and hippocampus were calculated. The occurrence of adverse reactions of both groups were recorded during treatment. Results After treatment, both groups exhibited decreased HAMD and NIHSS scores, and plasma Glu level, as well as Cho/Cr value in bilateral frontal lobes and hippocampus as compared with before treatment, whereas elevated levels of plasma DA, 5⁃HT, NE, GABA, and SS⁃QOL scale score, as well as values of NAA/Cr and MI/Cr in bilateral frontal lobes and hippocampus as compared with before treatment, among which the Traditional Chinese Medicine group yielded higher SS⁃QOL scale score, plasma DA, 5⁃HT, NE, and GABA levels, as well as higher values of NAA/Cr and MI/Cr in bilateral frontal lobes and hippocampus, whereas lower HAMD score, NIHSS score, plasma Glu level and Cho/Cr value in bilateral frontal lobes and hippocampus as compared with the Western Medicine group (P<0.05). There was no statistically significant difference in the incidence rate of adverse reactions between the two groups during treatment (P>0.05). Conclusion On the basis of Western Medicine therapy, acupuncture combined with Shugan Huoxue Decoction for treating post⁃stroke depression can alleviate patients' depressive symptoms, promote recovery of neurological function, and improve quality of life, exerting favorable safety. Its mechanism may be related to regulation of peripheral and central neurotransmitters levels in patients.

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