摘要
目的观察针刺配合盐酸氟西汀治疗轻中度抑郁症的临床疗效及其对下丘脑-垂体-肾上腺(HPA)轴相关促肾上腺皮质激素(ACTH)和皮质醇(CORT)水平的影响。方法将90例轻中度抑郁症患者随机分为A组、B组和C组,每组30例。A组采用针刺治疗,B组采用药物治疗,C组采用针刺配合药物治疗。观察3组治疗前后汉密尔顿抑郁量表(HAMD)评分、抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分、抑郁症症状快速自评量表(QIDS-SR)评分及血浆ACTH、CORT水平的变化情况,并比较3组临床疗效。结果3组治疗2周后各量表评分与同组治疗前比较,差异均具有统计学意义(P<0.05);3组治疗后各量表评分与同组治疗前及治疗2周后比较,差异均具有统计学意义(P<0.05)。B组和C组治疗2周后各量表评分与A组比较,差异均具有统计学意义(P<0.05)。C组治疗后HAMD评分和SAS评分与A组和B组比较,差异均具有统计学意义(P<0.05)。3组治疗后血浆ACTH、CORT水平均显著下降,与同组治疗前比较,差异均具有统计学意义(P<0.05)。A组总有效率为78.6%,B组为81.5%,C组为88.9%,3组总有效率组间比较,差异均无统计学意义(P>0.05)。结论针药并用治疗轻中度抑郁症起效快且疗效确切,其抗抑郁作用可能与调节HPA轴相关ACTH和CORT水平有关。
Objective To observe the clinical efficacy of acupuncture plus Fluoxetine Hydrochloride in treating mild-to-moderate depression and its effects on hypothalamus-pituitary-adrenal(HPA)axis-associated adrenocorticotropic hormone and cortisol(CORT)levels.Method Ninety patients with mild-to-moderate depression were randomized into groups A,B and C,with 30 cases in each group.Group A was treated with acupuncture,group B was intervened by medication,and group C was given acupuncture plus medication for treatment.The scores of Hamilton rating scale for depression(HAMD),self-rating depression scale(SDS),self-rating anxiety scale(SAS)and quick inventory of depressive symptomatology–self-report(QIDS-SR),and the levels of plasma ACTH and CORT were observed before and after treatment in the three groups.The clinical efficacy was also compared among the three groups.Result The scale scores changed significantly at 2-week treatment compared with the baseline in all the three groups(P<0.05);after treatment,the scale scores changed significantly compared with those before treatment and at 2-week treatment in all the three groups(P<0.05).At 2-week treatment,the scale scores in groups B and C were significantly different than those in group A(P<0.05).After treatment,the HAMD and SAS scores in group C were significantly different from those in groups A and B(P<0.05).The levels of ACTH and CORT declined notably after treatment in all the three groups compared with the baseline(P<0.05).The total effective rate was 78.6%in group A,81.5%in group B and 88.9%in group C.The between-group comparison of total effective rate showed statistically insignificant among the three groups(P>0.05).Conclusion Combining acupuncture and medication can act faster and is effective in treating mild-to-moderate depression,and its anti-depression effect may be associated with the regulation of HPA axis-associated ACTH and CORT levels.
作者
周竞
董烨卿
王雨宁
马桂芝
何婧
王雯
黄雨薇
张艾嘉
曾翡翠
王儒蒙
胡智海
王毅
ZHOU Jing;DONG Ye-qing;WANG Yu-ning;MA Gui-zhi;HE Jing;WANG Wen;HUANG Yu-wei;ZHANG Ai-jia;ZENG Fei-cui;WANG Ru-meng;HU Zhi-hai;WANG Yi(Shanghai TCM-integrated Hospital,Shanghai 200082,China;Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《上海针灸杂志》
2021年第11期1312-1317,共6页
Shanghai Journal of Acupuncture and Moxibustion
基金
上海市科学技术委员会科研计划项目(19401935500)
上海市虹口区“国医强优”三年行动计划(2018—2020年)针灸专科(HGY-YSZK-2018-03)
上海市虹口区“国医强优”三年行动计划(2018—2020年)盛氏六脉传承与发展(HGY-ZYCC-2018-01)
上海市虹口区“国医强优”三年行动计划(2018—2020年)
上海市虹口区名中医胡智海学术经验传承工作室(HGY-MZY-2018-18)
上海市卫生健康委员会中医重点专科培养项目-针灸专科。
关键词
针刺疗法
抑郁症
针药并用
下丘脑-垂体-肾上腺轴
促肾上腺皮质激素
皮质醇
Acupuncture therapy
Depressive disorder
Acupuncture medication combined
Hypothalamus-pituitary-adrenal axis
Adrenocorticotropic hormone
Cortisol
