“调任通督”针法治疗肝郁脾虚型轻中度抑郁障碍的疗效观察
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摘要
目的:观察调任通督针法治疗肝郁脾虚型轻中度抑郁障碍患者的有效性及安全性。方法:纳入60例符合诊断标准的研究对象,随机分为观察组和对照组,各30例。观察组予"调任通督"针法治疗,1周4次;对照组患者予口服舍曲林50 mg/天。共治疗4周。记录两组患者汉密尔顿抑郁量表(HAMD)评分、生存质量(WHOQOL-BREF)评分及药物副反应量表(SERS)评分,评价临床疗效。结果:观察组总有效率(93. 33%)高于对照组(80. 00%),差异显著(P <0. 05);两组治疗2周、4周后HAMD评分均较治疗前降低(P <0. 05),且观察组较对照组降低更加显著;两组治疗后生存质量评分均较治疗前有所提升(P <0. 05);治疗后观察组SERS评分低于对照组(P <0. 05)。结论:"调任通督"针法治疗肝郁脾虚型轻中度抑郁障碍安全有效,值得临床推广应用。
Objective: To observe the clinical efficacy and safety of Tiaoren Tongdu needling in treating mild to moderate depressive disorder with the syndrome of Liver-depression and Spleen-deficiency. Methods: 60 patients met the diagnosis criteria were randomly assigned into the observation group( n = 30) and the control group( n = 30). The observation group was treated with Tiaoren Tongdu needling( 4 times/week); the control group was treated with Sertraline( 50 mg/day). The treatment duration was four weeks. HAMD score,WHOQOL-BREF score,and SERS score were recorded and compared to evaluate the clinical effect in the two groups. Results: The total effective rate of the observation group was 93. 33%,which was significantly higher than 80. 00% of the control group( P < 0. 05). HAMD score was decreased in the two groups after two weeks and four weeks of the treatment( P < 0. 05); of which the decrease in the observation group was more significant than that in the control group( P < 0. 05). The quality of life scores in the two groups were improved after the treatment( P < 0. 05). The SERS score of the observation group was lower than that of the control group after the treatment( P < 0. 05). Conclusion: Tiaoren Tongdu needling is effective and safe for mild to moderate depressive disorder with the syndrome of Liver-depression and Spleen-deficiency,which is worth applying in clinic.
Objective: To observe the clinical efficacy and safety of Tiaoren Tongdu needling in treating mild to moderate depressive disorder with the syndrome of Liver-depression and Spleen-deficiency. Methods: 60 patients met the diagnosis criteria were randomly assigned into the observation group( n = 30) and the control group( n = 30). The observation group was treated with Tiaoren Tongdu needling( 4 times/week); the control group was treated with Sertraline( 50 mg/day). The treatment duration was four weeks. HAMD score,WHOQOL-BREF score,and SERS score were recorded and compared to evaluate the clinical effect in the two groups. Results: The total effective rate of the observation group was 93. 33%,which was significantly higher than 80. 00% of the control group( P < 0. 05). HAMD score was decreased in the two groups after two weeks and four weeks of the treatment( P < 0. 05); of which the decrease in the observation group was more significant than that in the control group( P < 0. 05). The quality of life scores in the two groups were improved after the treatment( P < 0. 05). The SERS score of the observation group was lower than that of the control group after the treatment( P < 0. 05). Conclusion: Tiaoren Tongdu needling is effective and safe for mild to moderate depressive disorder with the syndrome of Liver-depression and Spleen-deficiency,which is worth applying in clinic.
引文
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[15]户丽,梁佳,金树英,等.针刺治疗抑郁症作用机制近5年研究进展[J].针刺研究,2013,38(3):253-258.
[16]刘建,王爱爱,聂广宁,等.针刺治疗女性抑郁症:临床随机对照研究[J].中国针灸,2018,38(4):375-378.
[17]符文彬,樊莉,朱晓平,等.针刺治疗抑郁性神经症:多中心随机对照研究[J].中国针灸,2008,28(1):3-6.
[18]刘义,冯慧,莫亚莉,等.针刺对SSRI类抗抑郁药治疗抑郁症的增效作用及调节TH1/TH2平衡的研究[J].中华中医药学刊,2014,34(8):1927-1929.
[19]Hunt KJ,Coelho HF,Wider B,et al.Complementary and alternative medicine use in England:results from a national survey[J].Int J Clin Pract,2010,64(11):1496-1502.
[20]吴景竹,吴明,田利萍.舒肝解郁胶囊应用于轻中度抑郁症治疗的效果研究[J].中华中医药学刊,2018,36(6):1482-1484.
[21]尹冰,都群,都佳蕴,等.中医对抑郁症的治疗[J].中医临床研究,2017,9(1):77-78.
[22]施尤佳.调任通督针刺治疗中风后抑郁疗效及相关电位P3变化[J].山西中医,2017,33(10):15-16,40.
[2]Smith K.Mental health:a world of depression[J].Nature,2014,515(7526):181.
[3]钟华,陈莉.黛力新联合舒肝解郁胶囊治疗卒中后抑郁的疗效研究[J].重庆医学,2016,45(25):3496-3497,3500.
[4]Rush AJ Trivedi MH,Wisniewski SR,et al.Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps:a STAR*D report[J].Am J Psychiatry,2006,163(11):1905-1917.
[5]世界卫生组织.疾病和有关健康问题的国际统计分类(第10次修订本)[M].北京:人民卫生出版社,2008.
[6]国家技术监督局.中医临床诊疗术语·证候部分[S].北京:中国标准出版社,1997.
[7]中华中医药学会.中医内科常见病诊疗指南·西医疾病部分[M].北京:中国中医药出版社,2008:301.
[8]李跃华,相田园,张兰凤,等.抑郁症患者肝郁气滞及肝郁脾虚型HAMD抑郁量表结构因素分析[J].中国中医药信息杂志,2010,17(2):21-23.
[9]姚树娇,杨彦春.医学心理学[M].6版.北京:人民卫生出版社,2013:97.
[10]冼君定,谭健烽,万崇华,等.WHOQOL-BREF量表用于精神分裂症和抑郁症的信效度研究[J].中华疾病控制杂志,2015,19(5):500-503.
[11]沈渔邨.精神病学[M].3版.北京:人民卫生出版社,1994.
[12]李娜.抑郁症的中医药治疗浅述[J].中国中医药现代远程教育,2013,11(9):86-87.
[13]付佳林,汤臻,朱峰,等.舍曲林单用与合并不同剂量丁螺环酮治疗抑郁症患者的对照研究[J].临床精神医学杂志,2016,26(2):105-108.
[14]李凌江,马辛.中国抑郁障碍防治指南[M].2版.北京:人民卫生出版社,2015.
[15]户丽,梁佳,金树英,等.针刺治疗抑郁症作用机制近5年研究进展[J].针刺研究,2013,38(3):253-258.
[16]刘建,王爱爱,聂广宁,等.针刺治疗女性抑郁症:临床随机对照研究[J].中国针灸,2018,38(4):375-378.
[17]符文彬,樊莉,朱晓平,等.针刺治疗抑郁性神经症:多中心随机对照研究[J].中国针灸,2008,28(1):3-6.
[18]刘义,冯慧,莫亚莉,等.针刺对SSRI类抗抑郁药治疗抑郁症的增效作用及调节TH1/TH2平衡的研究[J].中华中医药学刊,2014,34(8):1927-1929.
[19]Hunt KJ,Coelho HF,Wider B,et al.Complementary and alternative medicine use in England:results from a national survey[J].Int J Clin Pract,2010,64(11):1496-1502.
[20]吴景竹,吴明,田利萍.舒肝解郁胶囊应用于轻中度抑郁症治疗的效果研究[J].中华中医药学刊,2018,36(6):1482-1484.
[21]尹冰,都群,都佳蕴,等.中医对抑郁症的治疗[J].中医临床研究,2017,9(1):77-78.
[22]施尤佳.调任通督针刺治疗中风后抑郁疗效及相关电位P3变化[J].山西中医,2017,33(10):15-16,40.