针灸对抑郁症患者主观报告结局指标的影响

目的:基于患者主观报告结局指标评价临床上针灸治疗抑郁症的疗效。方法:将符合纳入标准的163例抑郁症患者随机分为疏肝调神组、穴位浅刺组和非穴位浅刺组。疏肝调神组取四关穴(合谷、太冲)、百会、印堂进行常规针刺,在四花穴(膈俞、胆俞)艾炷直接灸,最后埋皮内针于心俞、肝俞;穴位浅刺组取穴同疏肝调神组,只是针刺深度较疏肝调神组浅,艾灸时间短于疏肝调神组;非穴位浅刺组取穴为疏肝调神组所取穴位旁开10mm处,操作方法同穴位浅刺组。3组患者每周治疗2次,共治疗12周。观察治疗后及治疗后1个月、3个月症状自评量表(SCL-90)评分,以评价疏肝调神针灸方案对治疗抑郁症的近期效应及中、远期疗效。结果:治疗后各时点,对于躯体化、强迫、抑郁、焦虑、敌对、偏执、精神病性及其他8个维度的评分,疏肝调神组与非穴位浅刺组比较,差异均有统计学意义(均P<0.05);对于抑郁、焦虑、敌对3个维度的评分,疏肝调神组与穴位浅刺组比较,差异均有统计学意义(均P<0.05)。结论:针灸可改善抑郁症患者SCL-90量表评分,运用患者主观报告结局指标可准确地评价临床疗效。

Impacts of acupuncture and moxibustion on outcome indeices of depression patients' subjective reports

Objective To assess the clinical efficacy of acupuncture and moxibustion on depression in view of the outcome indicators of the patient subjective reports.Methods One hundred and sixty-three cases of depression being in compliance with the inclusive standards were randomized into a soothing-liver and regulating-mind group,an acupoint-shallow-puncturing group and a non-acupoint-shallow-puncturing group.In the soothing-liver and re-gulating-mind group,the conventional acupuncture was applied to the four-gate points [Hegu(LI 4) and Taichong(LR 3)],Baihui(GV 20) and Yintang(EX-HN 3),the direct moxibustion with moxa cone was applied to the four-flower points [Geshu(BL 17),Danshu(BL 19)].Finally,the intradermal needling was used at Xinshu(BL 15) and Ganshu(BL 18).In the acupoint-shallow-puncturing group,the acupoints selected were same as those in the soothing-liver and regulating-mind group.But the needle insertion was shallower and the time of moxibustion was shorter.In the non-acupoint-shallow-puncturing group,the spots that were 10 mm lateral to those acupoints in the soothing-liver and regulating-mind group were selected.The operation was same as that in the acupoint-shallow-puncturing group.The treatment was given twice a week in three groups.Totally,12 weeks of treatment were required.The score of symptom checklist 90(SCL-90),the self-report symptom inventory was observed before treatment,1 month and 3 months after treatment separately so as to assess the corresponding short-term,mid-term and long-term efficacies of the program of acupuncture and moxibustion for soothing the liver and regulating the mind.Results In each time-point after treatment,for the scores of somatization,obsessive-compulsive symptom,interpersonal sensitivity,depression,anxiety,hostility,paranoid ideation,psychoticism and the other 8 dimensionalities,in comparison between the soothing-liver and regulating-mind group and the non-acupoint-shallow-puncturing group,the differences were significant statistically(all P<0.05).For the scores of depression, anxiety and hostility,in comparison between the soothing-liver and regulating-mind group and the acupoint-shallow-puncturing group,the differences were significant statistically(all P<0.05).Conclusion Acupuncture and moxibustion can improve the scores of SCL-90 scale for the patients with depression.The outcome indicators of the patient subjective reports can accurately assess the clinical efficacy.