基于RWS原则的电针抗抑郁临床案例研究  

Clinical case study of electro acupuncture anti depression based on RWS principle

作　　者：符馨文 王思涵[1] 孙岚[1] 图娅[1] 

机构地区：[1]北京中医药大学第一临床医学院,100029

出　　处：《环球中医药》2016年第10期1165-1169,共5页Global Traditional Chinese Medicine

基　　金：北京市科技计划课题(Z121100005512024)

摘　　要：目的采用真实世界研究方法(real world study,RWS)评估电针干预对抑郁症患者的症状改善及其整体病情的影响。方法将60例抑郁症患者随机分为药物组(n=25)与电针组(n=35),疗程8周。根据各时期汉密尔顿量表(Hamilton depression scale,HAMD)、总体印象量表(clinical global impression,CGI)和基于患者报告的症状量表(measure your medical outcome profile,MYMOP)评分变化情况对其疗效进行评价。结果 HAMD评分显示电针组的临床控制率、显效率、有效率、痊愈率均显著优于药物组(P<0.05);两组治疗后各周的HAMD评分均显著优于治疗前(P<0.05);从第4周开始,电针组的HAMD评分显著优于药物组(P<0.05);4周后随访,电针组的HAMD评分仍优于药物组。CGI量表显示,治疗8周后电针组在病情严重程度、疗效总评、疗效指数方面评分均显著优于药物组(P<0.05)。MYMOP量表显示,治疗8周后电针组症状1、症状2、活动、总体健康状况均优于药物组(P<0.05)。结论电针可显著改善抑郁症患者HAMD、CGI、MYMOP评分以及抑郁主要症状,整体疗效优于药物组。同时RWS的应用也表明电针抗抑郁在安全性及有效性的基础上也具有一定的外推性。Objective To evaluate the clinical effect of the external validity and security of electro acupuncture in the real treatment environment with the real world study method （ RWS ）. Methods Patients diagnosed with depression by the ICD-10 （n=60） were divided into two groups： （1） electro acu- puncture （EA） group （ n = 35 ） ; （2） western medicine group （ n = 25 ）. The Hamilton Depression （HAMD） scales, CGI scales, MYMOP scales were used to assess the main curative indexes during each period of the treatment. Results There was no significant difference between these two groups at baseline level （P〉0.05）. （ 1 ） HAMD： Compared with the western medicine group, the clinical control rate, markedly effective rate, cure rate, effective rate of EA group were significantly better than western medicine group （ P〈0.05 ）. In both of the two groups, there were statistically significant differences between baseline score of HAMD and the score in every treatment period（P〈0.05 ）. From the beginning of the fourth week, the HAMD score of EA group was significantly better than that of the western medicine group（P〈0.05 ）. And four weeks after treatment, the score of EA group was still better than the western medicine group; （2） CGI ： After 8 weeks of treatment, Compare with the western medicine group, score of CGI scale showed that severity of the disease, effective evaluation and effective index of EA group was significant differences better than those of western medicine group （ P〈0.05 ） ; （3） MYMOP ： After 8 weeks of treatment, compare with the western medicine group, the score of MYMOP scale, of EA group on symptom 1, symptom 2, activity and general health condition has significant differences （P 〈 0. 05 ）. Conclusion In real clinical conditions, EA treatment could improve the scores of HAMD, CGI and MYMOP significantly in patients with depression. Generally, the effect of EA treatment for depression is better than western medicine.

关 键 词：抑郁症 汉密尔顿量表 临床总体印象量表 基于患者报告的症状量表 

分 类 号：R249[医药卫生—中医临床基础]