针刺疗法改善美沙酮维持治疗门诊患者抑郁和焦虑症状疗效和安全性

目的:探讨针刺治疗改善美沙酮维持治疗(MMT)门诊患者的抑郁和焦虑症状的疗效和安全性。方法:采用随机双盲对照设计,将89例伴有抑郁和焦虑症状的MMT患者随机分为针刺组(48例)和伪针刺组(41例)。两组患者均维持原有的MMT治疗,针刺组行针刺治疗,穴取内关、合谷、足三里、三阴交等,伪针刺组行非穴点浅刺(取针刺组穴位旁5mm处),两组均连续治疗8周,每周5次;于基线、治疗每两周末患者自评完成SDS和SAS评价疗效,比较两组的针刺不良反应发生率以评价安全性。结果:重复测量方差分析显示,针刺组的抑郁自评量表和焦虑自评量表评分下降均高于伪针刺组,差异有统计学意义(F=5.99,P=0.005;F=8.36,P<0.001);针刺组和伪针刺组不良反应发生率分别为8.33%(4/48)和9.76%(4/41),差异无统计学意义(χ2=0.055,P=0.815)。结论:针刺疗法能安全有效的改善美沙酮维持治疗门诊患者的抑郁和焦虑症状。

Acupuncture Therapy for Depressive and Anxious Symptoms of Outpatients Receiving Methadone Maintenance Treatment: A Randomized Controlled Trial

Objective: To examine the efficacy and safety of acupuncture therapy for depressive and anxious symptoms of outpatients receiving methadone maintenance treatment(MMT).Methods: By using randomized double-blinded controlled design,eighty-nine MMT outpatients with obvious depressive and anxious symptoms,were randomly assigned to acupuncture group(n=48) and placebo-acupuncture group(n=41).All patients continued their previous MMT schemes.In acupuncture group,acupuncture was applied to Neiguan,Hegu,Zusanli,Sanyinjiao,etc.In placebo-acupuncture group,acupuncture was applied to non-acupoint spots(5 mm lateral to the acupoints selected in acupuncture group) with shallow needling technique.The treatment lasted for 8 weeks,5 sessions per week.For efficacy assessment,patients were administered SAS and SDS at baseline and every two-week interval.Adverse event rates were compared between two groups to assess the safety.Results: Repeated measurement variance analysis revealed that the overall SDS and SAS reduction of acupuncture group was significantly higher than placebo-acupuncture group(F=5.99,P=0.005;F=8.36,P<0.001).The adverse event rates of acupuncture were 8.33%(4/48) and 9.76%(4/41) for acupuncture group and placebo-acupuncture group,their difference was not statistically significant(x2=0.055,P=0.815).Conclusion: Acupuncture therapy can effectively and safely improve the depressive and anxious symptoms of outpatients receiving MMT.