“调督解郁法”电针治疗轻中度抑郁症的临床随机对照研究  

Efficacy of the Electroacupuncture with“Regulating the Governor Vessel to Relieve Depression”Method in Treating Mild to Moderate Depression:A Randomized Controlled Clinical Trial

作　　者：胥琨 殷萱 赵雯婷 吴焕淦[4] 徐世芬[1] XU Kun;YIN Xuan;ZHAO Wenting;WU Huanguan;XU Shifen(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Shanghai Tianshan Hospital of Traditional Chinese Medicine,Shanghai 200051,China;Nujiang Prefecture Hospital of Traditional Chinese Medicine,Lushui 673299,China;Shanghai Research Institute of Acupuncture and Meridian,Shanghai 200030,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071 [2]上海市长宁区天山中医医院,上海200051 [3]怒江州中医医院,泸水673299 [4]上海市针灸经络研究所,上海200030

出　　处：《世界科学技术-中医药现代化》2024年第11期2755-2762,共8页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：上海市科学技术委员会临床医学创新研究专项(22Y11922800):电针治疗轻中度首发抑郁症的随机对照试验,负责人:徐世芬;国家自然科学基金委员会面上项目(82274643):KMO调控Kyn-QA通路介导小胶质细胞活化及电针抗抑郁的神经保护机制研究,负责人:徐世芬。

摘　　要：目的评价“调督解郁法”电针治疗轻中度抑郁症的临床疗效。方法采用随机、单盲、平行对照设计,纳入抑郁症患者64人,按1∶1比例将患者分配到电针组和对照组。电针组取百会、神庭、印堂、内关、三阴交、合谷和太冲,电极连接百会、印堂,选择连续波型、频率2 Hz,每次治疗30 min,每周3次,共8周。对照组采用Streitberger不破皮安慰假针,取穴及疗程等与电针组相同,主要指标为汉密尔顿抑郁量表-17项(HAMD-17);次要指标包括抑郁症自评量表(PHQ-9)、焦虑自评量表(SAS)及健康调查简表(SF-36)。在治疗前、治疗后第4、8、12周随访时对患者进行相应指标评估。结果电针组完成病例31例,对照组完成30例,总脱落率4.7%。采用意向性治疗分析原则,在治疗第4、8、12周时,电针组的HAMD-17评分均低于对照组(P<0.01)。两组患者HAMD-17评分均随时间变化而降低,但电针组下降趋势更明显。第8周时,电针组PHQ-9和SAS评分均显著小于对照组(P<0.01),在SF-36精力、社会功能和精神健康3个维度的评分均高于对照组(P<0.01)。结论与假针刺相比,“调督解郁法”电针治疗能够更有效地改善轻中度抑郁症患者的抑郁情绪,缓解焦虑,并提升其生活质量。Objective To evaluate the clinical efficacy of electroacupuncture(EA)in the treatment of mild to moderate depression with the method of"Regulating the Governor Vessel to Relieve Depression".Methods In a randomized,single-blind,parallel-controlled design,64 patients with depression were enrolled and assigned to the EA group and the control group in a 1∶1 ratio.In the EA group,Baihui,Shenting,Yintang,Neiguan,Sanyinjiao,Hegu and Taichong were selected,electrodes were connected to Baihui and Yintang,continuous wave and frequency of 2 Hz were applied,and each session was given for 30 min,3 times a week for 8 weeks.The control group used Streitberger needles which couldn′t be inserted into the skin,and the acupoints and treatment course were the same as the EA group.The primary outcome was the 17-item Hamilton Depression Rating Scale(HAMD-17);secondary outcomes included the Patient Health Questionnaire(PHQ-9),the Self-rating Anxiety Scale(SAS)and the 36-item Short-form Health Survey(SF-36).Patients were assessed before treatment,at weeks 4 and 8 after treatment,and at the follow-up visit at week 12.Results 31 cases in the EA group finished the trial and 30 in the control group,with an overall dropout rate of 4.7%.Using the intention-to-treat analysis,patients’HAMD-17 scores in the EA group were lower than those in the control group at weeks 4,8 and 12 of treatment(P<0.01).HAMD-17 scores decreased over time in both groups,but the EA’s downward trend was more pronounced.At week 8,compared with the control group,the PHQ-9 and SAS scores were lower in the EA group(P<0.01),the EA group scored higher on all 3 dimensions of SF-36,energy,social functioning and mental health(P<0.01).Conclusion Compared with sham acupuncture,the EA treatment was more effective in improving depression,relieving anxiety and improving the quality of life of patients with mild to moderate depression.

关 键 词：电针 抑郁症 汉密尔顿抑郁量表 随机对照试验 

分 类 号：R245.31[医药卫生—针灸推拿学]