耳神门穴点压对社区老年期焦虑障碍患者焦虑症状的影响

  目的  探索耳神门穴点压对社区老年期广泛性焦虑障碍(GAD)的治疗效果及额叶功能的改善作用。  方法  选择2020年9月—2021年6月就诊于上海市静安区南京西路街道社区卫生服务中心及上海市长宁区精神卫生中心的老年期GAD患者90例，采用随机数字表法将患者随机分为耳穴刺激组(47例)和对照组(43例)，耳穴刺激组接受耳神门穴王不留行籽点压，对照组则对耳垂部进行点压，共8周。干预前后分别采用汉密尔顿焦虑量表(HAMA)、老年焦虑量表(GAI)及额叶功能量表(FAB)进行评估。  结果  耳穴刺激组与对照组在基线时点的人口学资料、焦虑症状及额叶功能差异均无统计学意义(均P＞0.05)。干预8周后，与对照组比较，耳穴刺激组的HAMA及GAI得分显著降低(15.41±6.79)分vs. (24.32±4.96)分，(7.97±2.71)分vs. (11.99±2.87)分, 均P＜0.05]，而FAB得分显著升高(10.79±3.41)分vs. (3.61±2.32)分, P＜0.05]。HAMA的减分值与FAB增分值呈负相关关系(r=-0.205，P=0.006)，HAMA躯体维度得分差值与GAI得分差值呈正相关关系(r=0.472，P＜0.001)。  结论  耳神门穴点压对社区老年期GAD患者的焦虑症状具有显著的改善作用，其作用机制可能与额叶功能改善相关。 

Effect of auricular Shenmen point pressure on anxiety symptoms of elderly patients with anxiety disorder in community

  Objective  This study aims to explore the effect of auricular Shenmen point pressure on generalised anxiety disorder (GAD) and the improvement of frontal lobe function in elderly people in community.  Methods  Between September 2020 and June 2021 in Jing' an district of Shanghai West Nanjing Road community health service centre and Changning district of Shanghai Mental Health Centre, 90 elderly patients with GAD were recruited and randomly divided into auricular point pressure (AP) group (n=47) and control group (n=43) by random number table. The AP group accepted the 8-week seed point pressure at the ear Shenmen acupoint. The Hamilton Anxiety Scale (HAMA) and Geriatric Anxiety Inventory (GAI) were used before and after intervention, respectively. Frontal assessment battery (FAB) was evaluated in the assessment of frontal lobe.  Results  No significant differences in demographic data, anxiety symptoms and frontal lobe function were found between AP and control groups at baseline (all P>0.05). After 8-week intervention, the HAMA and GAI scores in the AP group were significantly lower than the control group (15.41±6.79) points vs. (24.32±4.96) points, (7.97±2.71) points vs. (11.99±2.87) points, both P < 0.05], while the FAB scores significantly increased (10.79±3.41) points vs. (3.61±2.32) points, P < 0.05] compared with those in the control group. The decreasing score of HAMA was negatively correlated with the increasing score of FAB (r=-0.205, P=0.006). The decrease in the HAMA somatic dimension score was positively correlated with the increase in the GAI score (r=0.472, P < 0.001).  Conclusion  Auricular point pressure at Shenmen point can significantly improve anxiety symptoms in elderly patients with GAD in community, and its mechanism of action may be related to improvement of frontal lobe function.