针刺治疗精神分裂症顽固性幻听患者50例临床观察

Acupuncture Treatment for Refractory Auditory Hallucination in Schizophrenia Patients——A Report of 50 Cases

目的观察针刺治疗精神分裂症顽固性幻听的临床疗效和安全性。方法将临床确诊为精神分裂症顽固性幻听的100例患者随机分为试验组和对照组,每组50例。对照组单用维思通治疗,试验组在对照组治疗的基础上进行中医辨证分型后针刺治疗。1个月为1个疗程,共治疗3个疗程。观察两组临床疗效、试验组不同病程患者疗效,比较试验组各证型之间疗效;两组患者治疗前后采用简明精神病量表(BPRS)、特异性幻听量表(SHRS)及副反应量表(TESS)评分。结果试验组脱落3例,总有效率72.34%;对照组脱落1例,总有效率38.78%,两组比较差异有统计学意义(P<0.05);试验组病程≤2年患者总有效率85.71%高于病程>2年患者总有效率61.54%(P<0.05);试验组4种不同证型之间总有效率之间差异无统计学意义(P>0.05);两组患者BPRS、SHRS评分在第2、3疗程后同一时段比较差异均有统计学意义(P<0.05或P<0.01);试验组不良反应发生率31.91%低于对照组69.39%(P<0.05)。结论针刺治疗精神分裂症顽固性幻听的临床疗效较好且安全性较高。

Objective To observe the effect and safety of acupuncture treatment on refractory auditory hallucination in schizophrenia patients. Methods The 100 patients clinically diagnosed as refractory auditory hallucination of schizophrenia were randomized into test group and control group with 50 in each. The control group was treated with risperidone alone while the test group was treated with acupuncture on the basis of TCM syndrome differentiation in addition to risperidone. One month was one course,totally 3 courses of treatment was given. The clinical effect of both groups was observed. The effect in different courses of disease and the effect in different syndromes of the test group were compared respectively. Before and after treatment the brief psychiatric rating scale （BPRS）,specific auditory hallucination scale（SAHS）,and treatment emergent symptom scale （TESS） were adopted to score the patients of both groups. Results In the test group,there were 3 cases lost,the total effective rate was 72.34%; while in the control group,there was 1 case lost,the total effective rate was 38.78%,the difference being significant （P 0.05）. The patients of the test group with course of disease shorter than 2 years had a total effective rate 85.71%,higher than the total effective rate 61.54% of the patients with course longer than 2 years （P0.05）. There was no significant difference in the total effective rate among the 4 different syndromes in the test group （P0.05）. The difference in BPRS and SHRS scores at the same period of time after 2nd and 3rd courses of treatment of the two groups was significant （P0.05 or P0.01）. The adverse reaction rate in the test group was 31.91%,lower than 69.39% in the control group （P 0.05）. Conclusion Acupuncture treatment for the refractory auditory hallucination of schizophrenia is good in effect with a high safety.