电针与传统针刺治疗抑郁症的临床对照研究

目的观察电针与传统针刺治疗抑郁症的临床疗效和分析各自疗效特点。方法将144例抑郁症患者随机分为药物组54例(单纯SSRIs药物治疗)、针刺组44例(针刺+SSRIs药物)、电针组46例(电针+SSRIs药物)。分别观察三组治疗前和治疗后1、2、4、6星期及随访4星期HAMD量表总评分以及各因子分的变化情况。结果针刺组、电针组治疗后总有效率和愈显率与药物组比较差异均有统计学意义(P<0.05,P<0.01)。针刺组、电针组从治疗1星期起HAMD总分改善明显优于药物组(P<0.05,P<0.01),这种优势持续至治疗6星期后,到随访4星期时,电针组与药物组之间仍有差异(P<0.01)。HAMD因子分电针组与针刺组在焦虑/躯体化症状、睡眠障碍、认知和阻滞4个方面第1星期起与药物组即存在差异(P<0.05,P<0.01),其中针刺组与药物组在认知方面只在第1星期有差异(P<0.05),而电针组在第2星期认知方面比针刺组存在优势(P<0.05);随访4星期,电针组、针刺组在焦虑/躯体化症状因子方面与药物组比较仍有差异(P<0.01)。结论针药并用治疗抑郁症疗效优于单用药物治疗。与针刺组相比,电针在改善某些因子分、远期疗效方面存在一定优势,值得进一步研究。

Clinical Controlled Study on Electroacupuncture Versus Ordinary Acupuncture for Depression

Objective To study the clinical effect and specificity of electroacupuncture and traditional acupuncture in treating depression. Method A total of 144 patients with depression were randomized into a medication group of 54 cases （SSRIs）, an acupuncture group of 44 cases （acupuncture plus SSRIs）, and an electroacupuncture group of 46 cases （electroacupuncture plus SSRIs）. The general score and each item score in the Hamilton Depression Scale （HAMD） were observed before treatment, and at the end of first-week, second-week, fourth-week and sixth-week treatment, as well as in the 4-week follow-up study. Result The total effective rate and the cured and marked-effect rate in the acupuncture and electroacupuncture groups were both significantly different from that in the medication group （P〈0.05,P〈0.01）. Markedly Better improvements in the generalscore of HAMD were found in both acupuncture and electroacupuncture groups from the first-week treatment compared with that in the medication group （P〈 0.05,P〈0.01）, and this advantage was kept till the end of the six-week treatment. During the 4-week follow-up study, significant difference in comparing the general score was found between the electroacupuncture group and the medication group （P〈0.01）. Regarding the items of anxiety/somatic symptoms, sleep disorder, cognition and blockage, the results in the acupuncture group and electroacupuncture group were markedly different from that in the medication group since the first-week treatment （P〈0.05,P〈 0.01）. A significant difference in cognition was only found in the first-week treatment between the acupuncture group and medication group （P〈0.05）. The cognition score in the electroacupuncture group was obviously superior to that in the acupuncture group in the second-week treatment （P 〈 0.05）. During the 4-week follow-up study, the scores of anxiety/somatic symptoms in the electroacupuncture group and acupuncture group were still significantly different from that in the medication group （P〈0.01）. Conclusion Combined use of acupuncture and medication can achieve better result in treating depression compared with medication alone. Compared with acupuncture, electroacupuncture works better in improving some items and has better long-term effect, which is worth further study.