浮针疗法与度洛西汀治疗持续的躯体形式疼痛障碍的临床研究  

Treatment of Persistent Somatoform Pain Disorder by Floating Needle Therapy and Duloxetine

作　　者：任婉文[1] 周志英[2] 徐密密 龙森[4] 唐光政[1] 毛洪京[1] 陈树林[5] 

机构地区：[1]浙江省杭州市第七人民医院医学心理科,杭州310013 [2]浙江中医药大学附属第三医院针灸科,杭州310013 [3]浙江省杭州市萧山区中医院针灸科,杭州310013 [4]浙江省杭州市第七人民医院药剂科,杭州310013 [5]浙江大学心理系,杭州310013

出　　处：《中国中西医结合杂志》2016年第2期166-171,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：浙江省科技计划项目(No.2010C33119);浙江省杭州市科技发展计划医学重点专病专科专项(No.20091233Q16);浙江省杭州市卫生科技计划基金项目(No.2009B024)

摘　　要：目的观察浮针疗法与度洛西汀治疗持续的躯体形式疼痛障碍(persistent somatoform pain disorder,PSPD)患者的疗效和安全性。方法将108例PSPD患者随机分为浮针治疗组、度洛西汀组和安慰剂组,每组36例。浮针治疗组予浮针治疗并加服安慰剂,度洛西汀组服用盐酸度洛西汀肠溶片并接受模拟浮针治疗,安慰剂组服用安慰剂并接受模拟浮针治疗,各组均持续6周。分别于治疗前、治疗后即刻、治疗后1、2、4、6周末采用简易McGill疼痛量表(Simple McGill Pain Scale,SF-MPQ)、不良反应量表(Treatment Emergent Symptom Scale,TESS)评定疗效和不良反应;于治疗前、治疗后1、2、4、6周末评定汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD;17项)和汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)。浮针治疗组、度洛西汀组治疗6周末,SF-MPQ疼痛评定指数(Pain Rating Index,PRI)总分减分率≥50%者进入随访研究。结果(1)与本组治疗前比较,治疗1、2、4、6周各组患者SFMPQ各项评分、HAMD和HAMA总分均降低(P<0.05,P<0.01),且浮针治疗组在治疗后即刻SF-MPQ各项评分均降低(P<0.01)。与安慰剂组比较,浮针治疗组治疗1、2、4、6周SF-MPQ各项评分、HAMD和HAMA总分均降低(P<0.05,P<0.01),度洛西汀组治疗2、4、6周SF-MPQ各项评分、HAMD和HAMA总分亦降低(P<0.05,P<0.01)。(2)浮针治疗组出现不良反应3例(8.3%),度洛西汀组17例(50.0%),安慰剂组7例(21.2%)。与安慰剂组比较,度洛西汀组不良反应发生率升高(χ~2=6.04,P<0.05),且度洛西汀组不良反应发生率高于浮针治疗组(χ~2=14.9,P<0.05)。(3)浮针治疗组19例和度洛西汀组17例进入随访。与治疗6周末比较,随访3、6个月时SF-MPQ各项评分、HAMD和HAMA评分差异均无统计学意义(P>0.05);两组间比较,差异均亦无统计学意义(P>0.05)。随访中度洛西汀组5例(29.4%)发生不良反应,浮针治疗组无不良反应(0),两组不良反应发生率比较,差异有统计学意�Objective To evaluate clinical effect and safety of floating needle therapy and duloxetine in treating patients with persistent somatoform pain disorder（PSPD）.Methods Totally 108 PSPD patients were randomly assigned to the floating needle treatment group,the duloxetine treatment group,and the placebo treatment group,36 in each group.Patients in the floating needle treatment group received floating needle therapy and placebo.Those in the duloxetine treatment group received duloxetine and simulated floating needle therapy.Those in the placebo treatment group received the placebo and simulated floating needle therapy.All treatment lasted for six weeks.Efficacy and adverse reactions were evaluated using Simple McGill pain scale（SF-MPQ） and Treatment Emergent Symptom Scale（TESS） before treatment and immediately after treatment,as well as at the end of 1st,2nd,4th,and 6th week of treatment,respectively.Hamilton Depression Scale（HAMD,17 items）,Hamilton Anxiety Scale（HAMA） were assessed before treatment and at the end of 1st,2nd,4th,and 6th week of treatment,respectively.Patients in the floating needle treatment group and the duloxetine treatment group with the total reducing score rate of SF-MPQ in Pain Rating index（PRI） 3=50%after 6 weeks’ treatment were involved in the follow-up study.Results（1） Compared with the same group before treatment,SF-MPQ score,HAMD score and HAMA total scores all decreased in all the three groups at the end of 1st,2nd,4th,and 6th week of treatment（P 〈0.05,P 〈0.01）.Besides,each item of SF-MPQ significantly decreased immediately after treatment in the floating needle treatment group（P 〈0.01）.Compared with the placebo treatment group,SF-MPQ,HAMD,and HAMA total score in the floating needle treatment group significantly decreased after 1,2,4,and 6 weeks of treatment（P 〈0.05,P 〈0.01）.SF-MPQ score,HAMD score and HAMA total score in the duloxetine treatment group also significantly decreased after 2,4,and 6 weeks of treatment（P 〈0.05,P 〈0.01�

关 键 词：浮针疗法 度洛西汀 持续的躯体形式疼痛障碍 

分 类 号：R749.7[医药卫生—神经病学与精神病学]