摘要
目的:观察耳穴埋针对抑郁症患者盐酸舍曲林减药率及远期疗效的影响。方法:将符合减药标准的72例抑郁症患者随机分为观察组(36例,脱落1例)和对照组(36例,脱落2例)。对照组采用常规减药法,即在患者抑郁症状不加重的前提下,每周减少盐酸舍曲林25%的药量至最终彻底停药;观察组在对照组常规减药法基础上,于心、肝、神门、皮质下、内分泌穴采用耳穴埋针,每3天1次,连续治疗4周。在减药前和减药1、2、3、4周后及治疗结束后6个月随访时观察两组服药量;于减药4周后及随访时观察两组减药率;于减药前、减药4周后及随访时,采用汉密尔顿抑郁量表(HAMD)评估两组抑郁程度,并比较两组撤药综合征发生率及临床疗效。结果:减药2、3、4周后及随访时,观察组盐酸舍曲林服药量均少于对照组(P<0.05)。减药4周后及随访时,观察组减药率分别为80.6%、82.2%,高于对照组的65.8%、62.2%(P<0.05)。减药4周后,两组HAMD评分较减药前升高(P<0.05),但观察组低于对照组(P<0.05);随访时,观察组HAMD评分低于对照组及减药4周后(P<0.05),而对照组HAMD评分较减药前、治疗4周后升高(P<0.05)。观察组撤药综合征发生率为11.4%(4/35),低于对照组的47.1%(16/34,P<0.05)。减药4周后及随访时,观察组总有效率均为97.1%(34/35),均低于对照组的79.4%(27/34,P<0.05)。结论:耳穴埋针可有效减少抑郁症患者盐酸舍曲林服药量,提高减药率,降低撤药综合征发生率,减少远期复发风险。
Objective To observe the effect of auricular acupuncture on reduction rate of sertraline hydrochloride,and to explore the long-term efficacy of auricular acupuncture in patients with depression.Methods Seventy-two patients with depression were randomly divided into an observation group(36 cases,1 case dropped off)and a control group(36 cases,2 cases dropped off).The patients in the control group were treated with conventional dosage reduction method,that is,the dosage of sertraline hydrochloride was reduced by 25%every week until the dosage was stopped completely on the premise of no aggravation of depressive symptoms.Based on the conventional dosage reduction method used in the control group,the patients in the observation group were treated with auricular acupuncture at Xin(CO15),Gan(CO12),Shenmen(TF4),Pizhixia(AT4)and Neifenmi(CO18),once every 3 days for 4 weeks.The reduction of dosage was observed before dosage reduction,after 1,2,3,4 weeks of dosage reduction and follow-up 6 months after the end of treatment;the rate of dosage reduction was observed after 4 weeks of dosage reduction and during follow-up;the Hamilton depression scale(HAMD)was used to evaluate the depression severity before dosage reduction,after 4 weeks of dosage reduction and during follow-up;the incidence rate of withdrawal syndrome and clinical efficacy were compared between the two groups.Results The dosage of sertraline hydrochloride in the observation group was less than that in the control group after 2,3,4 weeks of dosage reduction and during follow-up(P<0.05).The dosage reduction rates were 80.6%and 82.2%after 4 weeks of dosage reduction and during follow-up in the observation group,which were higher than 65.8%and 62.2%in the control group(P<0.05).After 4 weeks of dosage reduction,the HAMD scores in the two groups were higher than those before dosage reduction(P<0.05),and the HAMD score in the observation group was lower than that in the control group(P<0.05).During follow-up,HAMD score in the observation group was lower than that in
作者
蔡慧倩
粟胜勇
张熙
代琪
黄梅
林安
CAI Hui-qian;SU Sheng-yong;ZHANG Xi;DAI Qi;HUANG Mei;LIN An(First Clinical Medical College of Guangxi University of CM,Nanning 530023,China;Department of Acupuncture and Moxibustion,First Affiliated Hospital of Guangxi University of CM,Nanning 530023)
出处
《中国针灸》
CAS
CSCD
北大核心
2021年第9期1005-1009,共5页
Chinese Acupuncture & Moxibustion
基金
十二五科技支撑计划分课题项目:2012BAI24B01。
关键词
抑郁症
耳穴埋针
盐酸舍曲林
减药率
撤药综合征发生率
depression
auricular acupuncture
sertraline hydrochloride
dosage reduction rate
incidence rate of withdrawal syndrome
