针刺治疗轻度焦虑症临床疗效的真实世界研究  

Clinical Efficacy of Acupuncture in the Treatment of Mild Anxiety:a Real World Study

作　　者：崔伟锋[1] 范军铭[1] 叶静 庆慧[1] CUI Weifeng;FAN Junming;YE Jing;QING Hui(Henan Academy of Chinese Medicine,Zhengzhou 450004,China;Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南省中医药研究院,河南省郑州市450004 [2]河南中医药大学,河南省郑州市450046

出　　处：《中国全科医学》2021年第3期341-347,共7页Chinese General Practice

基　　金：国家自然科学基金资助项目(81273877);河南省中医药科学研究专项重点项目(2014ZY01005)。

摘　　要：背景多项随机对照试验表明针刺治疗焦虑症具有较好的临床疗效,但目前尚缺乏真实世界研究证据。目的基于真实世界研究探讨针刺治疗焦虑症的临床疗效。方法选取2016年9月-2018年9月河南省中医药研究院附属医院收治的轻度焦虑症患者276例,先根据住院期间针刺治疗情况分为针刺组149例和非针刺组127例,再根据倾向性评分值及1∶1匹配原则进行配对,最终75对病例匹配成功。比较匹配前后两组患者临床疗效,治疗前及治疗6、8周汉密尔顿焦虑量表(HAMA)评分、匹兹堡睡眠质量指数(PSQI)总分。结果匹配前针刺组、非针刺组患者总有效率分别为91%(136/149)、82%(104/127),匹配后针刺组、非针刺组患者总有效率分别为97%(73/75)、87%(65/75);匹配前、后两组患者总有效率比较,差异有统计学意义(P<0.05)。时间与方法在匹配前、后HAMA评分及PSQI总分上存在交互作用(P<0.05);时间和方法在匹配前、后HAMA评分及PSQI总分上主效应显著(P<0.05);匹配前、后针刺组患者治疗8周HAMA评分及治疗6、8周PSQI总分均低于非针刺组(P<0.05)。结论基于真实世界的证据表明针刺治疗轻度焦虑症有效,可减轻患者焦虑程度,改善患者睡眠质量,且安全、可行。Background Multiple randomized controlled trials have showed that acupuncture has good clinical efficacy in the treatment of anxiety,but related real-world study evidence is lacking so far.Objective To explore the clinical efficacy of acupuncture in the treatment of mild anxiety based on a real-world study.Methods A total of 276 patients with mild anxiety were selected from the Affiliated Hospital of Henan Academy of Chinese Medicine,and were first divided into acupuncture group(n=149)and non-acupuncture group(n=127)according to the prevalence of acupuncture treatment,and then the groups were matched by a 1:1 propensity score matching methodology,yielding 75 pairs.Comparison was conducted between the two groups for clinical efficacy,Hamilton Anxiety Rating Scale(HAMA)score and total score of Pittsburgh Sleep Quality Index(PSQI)before treatment and 6 and 8 weeks after treatment.Results Pre-matching overall response rate of acupuncture group and non-acupuncture group was 91%(136/149)and 82%(104/127),respectively,showing a significant difference(P<0.05).Furthermore,post-matching overall response rates of acupuncture and non-acupuncture groups〔97%(73/75)vs 87%(65/75)〕still had a significant difference(P<0.05).There was significant interaction between treatment time and method on pre-and post-matching HAMA score or total score of PSQI(P<0.05).The main effect of treatment time and method was significant on pre-and post-matching HAMA score(P<0.05).The main effect of treatment time and method was significant on pre-and postmatching total score of PSQI(P<0.05).Compared to non-acupuncture group,acupuncture group had lower HAMA score after 8 weeks of treatment,as well as lower total score of PSQI after 6 and 8 weeks of treatment either before or after matching(P<0.05).Conclusion Our real-world evidence suggests that acupuncture may be effective in reducing the severity of mild anxiety and improving the quality of life in mild anxiety patients,with high safety and feasibility.

关 键 词：焦虑症 针刺疗法 真实世界研究 倾向性评分 治疗结果 

分 类 号：R749.72[医药卫生—神经病学与精神病学] R245.3[医药卫生—临床医学]