电针与认知行为治疗持续性躯体形式疼痛障碍的临床研究

Cupping and Cognitive Behavioral Therapy Persistent Somatoform Disorders of Pain in Clinical Research

目的研究电针、认知行为心理治疗与二者联合在抗抑郁药物治疗基础上治疗持续性躯体形式疼痛障碍的疗效的差别。方法对65名持续性躯体形式疼痛障碍患者追踪观察1年,治疗前将患者随机分为3组;在抗抑郁药物治疗基础上,一组接受电针治疗(简称电针组);一组接受认知行为治疗(简称心理组);一组接受电针联合认知行为治疗(简称电针心理治疗组)。对3组治疗前与后2、4、8周以及半年,1年各进行1次疼痛症状评分,汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)测评,以及1年后复发率的对比。结果电针及电针联合认知行为治疗组2周、4周时的疗效优于认知行为治疗组(P<0.05);1年时,认知行为治疗组与电针认知行为治疗组疗效相当,但明显优于电针治疗组(P<0.05);且二者复发率较电针治疗组低(P<0.05)。结论在抗抑郁药物治疗基础上配合电针治疗能快速缓解患者的疼痛症状及焦虑抑郁情绪,而配合认知行为治疗能纠正患者的不良认知,从而减少持续性躯体形式疼痛障碍复发;故电针配合认知行为治疗是对持续性躯体形式疼痛障碍的更为有效的治疗方式。

Objective To study the electro-acupuncture,Cognitive Behavior therapy and the two combined in the anti-depressant drugs（hydrochloride Paluoxiding paroxetine）therapy based on the treatment of persistent somatoform pain disorder effect of the difference.Methods 65 persistents somatoform pain disorder durative somatoform pain disorder followed for 1 year before treatment,patients were randomly divided into 3 groups;On the basis of the antidepressant drug treatment,one group received acupuncture treatment（referred to as the EA group）;a group cognitive behavioral therapy（referred to as mental group）;one group received electroacupuncture combined with cognitive behavioral therapy（referred to as electro-acupuncture therapy group）.Of the 3 groups before treatment and after 2,4,8 weeks and six months,1 year each for 1 symptom score,Hamilton Depression Scale（HAMD）And the Hamilton Anxiety Scale（HAMA）evaluation,and 1-year recurrence rate after contrast.Results The results of EA and EA combined cognitive behavioral therapy group 2 weeks,4 weeks is more effective than cognitive behavioral therapy group（P0.05）;1 year,cognitive behavioral therapy group and cognitive behavioral therapy,electroacupuncture group of very effective,but much better than EA treatment group（P0.05）;and the recurrence rate between the two acupuncture treatment group compared with the low（P0.05）.Conclusion Based on the antidepressant drug treatment with electroacupuncture for treatment of patients can quickly relieve pain and anxiety and depression,and with cognitive behavioral therapy to correct the negative perception of patients,thus reducing the persistent somatoform pain disorder relapse;it electroacupuncture combined with cognitive behavioral therapy is a persistent somatoform pain disorder in a more effective treatment.