疏肝调神法针刺联合西药治疗新冠疫情隔离经历致抑郁失眠共病:多中心随机对照试验  

Effect of Shugan Tiaoshen acupuncture combined with western medication on depression-insomnia comorbidity due to COVID-19 quarantine:a multi-central randomized controlled trial

作　　者：阎路达 李仲贤 张瑜 梁雪松 李晶晶[2,3,4] 吴苗 石国傲 陈锐明 吉祥 左思垚 陈世云 周鹏 符文彬[1,4,5] YAN Lu-da;LI Zhong-xian;ZHANG Yu;LIANG Xue-song;LI Jing-jing;WU Miao;SHI Guo-ao;CHEN Rui-ming;JI Xiang;ZUO Si-yao;CHEN Shi-yun;ZHOU Peng;FU Wen-bin(Second Clinical Medicine College,Guangzhou University of CM,Guangzhou 510405,Guangdong Province,China;Department of Acupuncture and Moxibustion,Shenzhen Bao'an TCM Hospital,Shenzhen 518100,Guangdong Province;Shenzhen Bao'an Research Center for Acupuncture and Moxibustion,Shenzhen 518100,Guangdong Province;Shenzhen Government"Medical Health Project",Professor FU Wen-bin's Team of Guangdong Provincial Hospital of TCM,Shenzhen 518100;Guangdong Provincial Hospital of TCM,Guangzhou 510120)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]深圳市宝安区中医院针灸科,广东深圳518100 [3]深圳市宝安区针灸临床研究中心,广东深圳518100 [4]深圳市人民政府“医疗卫生三名工程”广东省中医院符文彬教授团队,广东深圳518100 [5]广东省中医院,广州510120

出　　处：《中国针灸》2023年第3期255-260,共6页Chinese Acupuncture & Moxibustion

基　　金：深圳市人民政府“医疗卫生三名工程”广东省中医院符文彬教授针灸学团队项目:SZSM201806077;深圳市宝安区针灸临床研究中心项目:BAZJ2018239;深圳市宝安区中医药发展基金项目:2020KJCX-KTYJ-10。

摘　　要：目的:观察疏肝调神法针刺联合西药对新型冠状病毒感染(简称“新冠”)疫情隔离经历所致抑郁失眠共病患者抑郁情绪及睡眠质量的影响,并从皮层兴奋性角度探讨其可能机制。方法:将60例新冠疫情隔离经历致抑郁失眠共病患者随机分为针刺组和假针刺组,各30例。两组均口服盐酸舍曲林片,针刺组采用疏肝调神法针刺(毫针取印堂、百会、合谷、照海、气海等,耳穴揿针取心、肝、肾)治疗,假针刺组采用假针刺(取穴同针刺组)治疗(随访结束后有补偿性治疗),两组均每2天治疗1次,每周3次,连续治疗8周。比较两组治疗前后及治疗结束后1个月(随访时)抑郁自评量表(SDS)评分及失眠严重程度指数(ISI)评分;检测两组治疗前后皮层兴奋性指标[静息运动阈值(rMT)、运动诱发电位振幅(MEP-A)、皮层静息期(CSP)]和血清5-羟色胺(5-HT)含量。结果:治疗后及随访时,两组患者SDS、ISI评分均较治疗前降低(P<0.05),且针刺组低于假针刺组(P<0.05),针刺组治疗后降低幅度大于假针刺组(P<0.05)。治疗后,针刺组患者r MT较治疗前降低(P<0.05),MEP-A、CSP较治疗前升高(P<0.05),两组血清5-HT含量较治疗前升高(P<0.05);针刺组r MT低于假针刺组,MEP-A、CSP及血清5-HT含量高于假针刺组(P<0.05)。结论:疏肝调神法针刺联合西药能够改善新冠疫情隔离经历致抑郁失眠共病患者的抑郁情绪和睡眠质量,可能与纠正失衡的兴奋性与抑制性神经元功能有关。Objective To observe the effect of Shugan Tiaoshen acupuncture(acupuncture for soothing the liver and regulating the mentality)combined with western medication on depression and sleep quality in the patients with depression-insomnia comorbidity due to COVID-19 quarantine,and investigate the potential mechanism from the perspective of cortical excitability.Methods Sixty patients with depression-insomnia comorbidity due to COVID-19 quarantine were randomly divided into an acupuncture group and a sham-acupuncture group,30 cases in each one.The patients of both groups were treated with oral administration of sertraline hydrochloride tablets.In the acupuncture group,Shugan Tiaoshen acupuncture was supplemented.Body acupuncture was applied to Yintang(GV 24+),Baihui(GV 20),Hegu(LI 4),Zhaohai(KI 6),Qihai(CV 6),etc.The intradermal needling was used at Xin(CO15),Gan(CO12)and Shen(CO10).In the sham-acupuncture group,the sham-acupuncture was given at the same points as the acupuncture group.The compensatory treatment was provided at the end of follow-up for the patients in the sham-acupuncture group.In both groups,the treatment was given once every two days,3 times a week,for consecutive 8 weeks.The self-rating depression scale(SDS)and insomnia severity index(ISI)scores were compared between the two groups before and after treatment and 1 month after the end of treatment(follow-up)separately.The cortical excitability indexes(resting motor threshold[r MT],motor evoked potential amplitude[MEP-A],cortical resting period[CSP])and the level of serum 5-hydroxytryptamine(5-HT)were measured before and after treatment in the two groups.Results After treatment and in follow-up,SDS and ISI scores were decreased in both groups compared with those before treatment(P<0.05),and the scores in the acupuncture group were lower than those in the sham-acupuncture group(P<0.05),and the decrease range in the acupuncture group after treatment was larger than that in the sham-acupuncture group(P<0.05).After treatment,rMT was reduced(P<0.05),while M

关 键 词：抑郁失眠共病 新型冠状病毒感染 隔离 针刺 皮层兴奋性 神经可塑性 

分 类 号：R246.6[医药卫生—针灸推拿学]