Clinical observation of acupuncture combined with medication for mild-to-moderate depression  

针药并用治疗轻中度抑郁症临床观察

作　　者：DILINUER Abulikemu ITTIPALANUKUL Penpat WU Pengtao HU Xinyi ZHANG Aijia HUANG Yuwei CHE Ruiqi WANG Yi HU Zhihai 迪丽努尔·阿布力克木;ITTIPALANUKUL Penpat;武鹏涛;胡欣翌;张艾嘉;黄雨薇;车瑞琦;王毅;胡智海(Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai Pudong New Area Puxing Community Health Service Center,Shanghai 200139,China;Shanghai TCM-Integrated Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200082,China)

机构地区：[1]Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China [2]Shanghai Pudong New Area Puxing Community Health Service Center,Shanghai 200139,China [3]Shanghai TCM-Integrated Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200082,China

出　　处：《Journal of Acupuncture and Tuina Science》2024年第5期400-409,共10页针灸推拿医学（英文版）

基　　金：上海市科学技术委员会医学创新研究专项面上项目,No.21Y11923500;上海市虹口区国医强优项目,No.HKGYQYXM-2022-17;上海市文化和旅游局项目:盛氏针灸疗法.

摘　　要：Objective:To discuss the clinical efficacy and plausible mechanism of Tiao Yang Qu Xie(regulating Yang to eliminate pathogenic factors)needling method plus paroxetine in treating mild-to-moderate depression.Methods:Sixty-six patients with mild-to-moderate depression were divided into an observation group and a control group using the random number table method,each consisting of 33 cases.Another 25 healthy subjects were recruited as a healthy group.The control group took oral paroxetine tablets for treatment,and the observation group received additional acupuncture treatment 3 times weekly.Both groups underwent 4-week treatment.Before treatment,after 2-week and 4-week treatment,and 2 weeks after treatment(follow-up),the patients were assessed using the Hamilton depression scale-17-item(HAMD-17),self-rating depression scale(SDS),self-rating anxiety scale(SAS),and traditional Chinese medicine(TCM)pattern element identification scale for depression.The two groups each randomly contributed 25 cases to detect the protein content of brain-derived neurotrophic factor(BDNF)before treatment and after 4-week treatment,and compared with the healthy group.Results:After 2-week treatment,the markedly effective and total effective rates were significantly higher in the observation group than in the control group(P<0.05);after 4-week treatment,the observation group significantly surpassed the control group in comparing the markedly effective rate(P<0.05).After 2 and 4 weeks of treatment and at the follow-up,the HAMD-17 total score and sleep disorder factor score were lower in the observation group than in the control group(P<0.05);the anxiety-somatic score was lower in the observation group than in the control group after 2-week treatment(P<0.05).After 2 and 4 weeks of treatment and at the follow-up,the observation group was lower than the control group in comparing the scores of SDS,SAS,and TCM pattern element identification scale for depression(P<0.05).After 4-week treatment,the observation group had an increased serum BDNF pr目的:探讨调阳祛邪针法联合帕罗西汀治疗轻中度抑郁症的临床疗效及可能机制。方法:将66例轻中度抑郁症患者按随机数字表法分为观察组和对照组,每组33例。招募健康志愿者25例作为健康组。对照组口服帕罗西汀片治疗;观察组在对照组治疗基础上加用针刺治疗,每周3次。两组均治疗4周。在治疗前、治疗2周后、治疗4周后及治疗结束2周后(随访)评估患者汉密尔顿抑郁量表-17(HAMD-17)、抑郁自评量表(SDS)、焦虑自评量表(SAS)和抑郁症中医证候要素辨证量表评分。两组各随机抽取25例于治疗前及治疗4周后检测脑源性神经营养因子(BDNF)蛋白含量,并与健康组进行比较。结果:治疗2周后,观察组显效率和总有效率均显著高于对照组(P<0.05);治疗4周后,观察组显效率显著高于对照组(P<0.05)。观察组HAMD-17总分及睡眠障碍因子总分在治疗2周和4周后以及随访时均低于对照组(P<0.05);观察组焦虑/躯体化因子总分仅在治疗2周后低于对照组(P<0.05)。治疗2周后、治疗4周后及随访时,观察组SDS、SAS和抑郁症中医证候要素辨证量表评分均低于同时间点对照组评分(P<0.05)。治疗4周后,观察组患者血清BDNF蛋白含量显著升高,且高于对照组(P<0.05),与健康组比较无统计学差异(P>0.05)。结论:针刺联合帕罗西汀治疗轻中度抑郁症的疗效优于单独口服帕罗西汀,且在改善睡眠障碍和焦虑躯体化症状方面起效更快;增加血清BDNF蛋白含量可能是其抗抑郁作用的部分机制。

关 键 词：Acupuncture Therapy Acupuncture Medication Combined DEPRESSION ANXIETY Brain-Derived Neurotrophic Factor Randomized Controlled Trial 

分 类 号：R246.6[医药卫生—针灸推拿学]