针刺疗法对轻中度抑郁症患者停药后睡眠质量及停药症状的影响  

Effects of acupuncture on withdrawal symptoms and long-term recurrence in depressed patients

作　　者：张骏 谌先召[2] Zhang Jun;Chen Xianzhao(Department of Psychiatry, Wuhan Mental Health Center, Wuhan 430000, China;Department of Encephalopathy, Wuhan Hospital of Traditional Chinese Medicine, Wuhan 430000, China)

机构地区：[1]湖北省武汉市精神卫生中心精神科,430000 [2]湖北省武汉市中医医院脑病科,430000

出　　处：《国际中医中药杂志》2019年第7期706-710,共5页International Journal of Traditional Chinese Medicine

摘　　要：目的探讨针刺疗法对轻中度抑郁症患者停药后睡眠质量及停药症状的影响。方法对符合停药标准并行抑郁症停药治疗的70例患者进行回顾性分析,按停药方法分为2组,每组35例。对照组采用常规停药方法,观察组采用针刺联合常规停药方法。2组均治疗6周,随访1年。采用汉密尔顿抑郁量表(Hamilton depression scale, HAMD)评估抑郁程度,采用匹兹堡睡眠质量量表(Pittsburgh Sleep Quality Index, PSQI)评估睡眠质量,观察停药综合征的发生情况并统计停药成功率及复发率。结果停药后1年,观察组停药综合征发生率为11.4%(4/35)、对照组为31.4%(11/35),2组比较差异有统计学意义(χ2=4.158,P=0.041);观察组停药成功率为88.6%(31/35)、复发率为9.7%(3/31),对照组停药成功率为68.6%(24/35)、复发率为41.7%(10/24),2组停药成功率与复发率比较,差异均有统计学意义(χ2值分别为4.158、7.669,P<0.05)。停药后1年,观察组睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能、催眠药物评分及PSQI总分均低于对照组(t值分别为2.228、2.327、2.888、2.329、2.173、2.092、2.535、9.951,P<0.05或P<0.01)。观察组停药后1周、1年HAMD评分低于对照组(t值分别为9.271、14.238,P<0.01)。结论针刺治疗可有效提高轻中度抑郁症患者停药后的睡眠质量,降低停药综合征发生率,减少远期复发风险。Objective To observe the effects of acupuncture therapy on sleep quality after drug withdrawal symptoms and long-term recurrence in patients with depression. Methods A total of 70 depression patients were retrospectively analyzed, according to the withdrawal method is divided into two groups, each group of 35 cases. The incidence of drug withdrawal syndrome in the two groups was observed and the success rate of drug withdrawal was calculated. The recurrence rate of depression in the two groups within one year after drug withdrawal, and the sleep quality were observed. The degree of depressive symptoms were assessed. Results The incidence of drug withdrawal syndrome were 11.4% in the observation group and 31.4% in the control group, which the difference was statistically significant (χ2=4.158, P=0.041). The rate of recurrence of depression was 9.7% in the observation group and 41.7% in the control group, which the observation group was significantly lower than the control group (χ2=7.669, P=0.006). After 1 year the drug was stopped, the sleep quality, sleep time, sleep efficiency, sleep disorder, daytime function and hypnotic drug score and total scores of PSQI of the observation group were significantly increased (P<0.01). And the PSQI at different time frames were significantly lower than those of the control group (t value were 2.888, 2.329, 2.092, 2.535, 9.951, P<0.05 or P<0.01). The HAMD score of the observation group 1 week after drug withdrawal and 1 year after drug withdrawal was significantly lower than those of the control group (t value were 9.271, 14.238, P<0.05). Conclusions The acupuncture therapy can improve the sleep quality of patients with mild and moderate depression after drug withdrawal, and reduce the incidence of drug withdrawal syndrome, and the risk of long-term recurrence.

关 键 词：抑郁症 针刺疗法 穴位 头针刺激区 穴位 耳针 停药后睡眠质量 停药综合征 远期复发率 

分 类 号：R246.6[医药卫生—针灸推拿学]