针刺作为辅助手段治疗精神分裂症的探索性病例研究(英文)

A case study exploration of the value of acupuncture as an adjunct treatment for patients diagnosed with schizophrenia:results and future study design

目的:探索个体针刺疗法作为常规治疗的辅助手段在精神分裂症患者中的效果;采用探索性病例研究的方法,使用定量和定性评价工具,以便能够对针刺治疗此类患者的确切疗效作出科学评价,并对未来采用针刺治疗此类患者的试验设计提供方法学建议。方法:共纳入11例精神分裂症患者,在予以10周的针刺治疗前,治疗过程中及治疗后分别采用多种有效的定量和定性评价工具对患者进行多方面的评价。这些评价手段包括对针刺治疗、全科医生及精神科医生病历的整理回顾。分析定性资料以评价受试者向研究者及其临床医生和护理人员报告的内容的可靠性。结果:11名受试者中共有8名完成了1个疗程的针刺治疗,全部11名受试者都报告了针刺治疗的积极作用,包括精神分裂症症状的改善,缓解药物的副作用,对精力、内在动机、睡眠、成瘾症状及其他身体机能的促进作用。但是,受试者向研究者和针刺医生报告的信息在不同治疗阶段有一定差别,且往往不一致;在研究结束后,受试者向研究者报告了更多的信息。结论:本研究表明,在常规疗法之外辅以针刺治疗能够给精神分裂症病人带来一定益处。对数据的三角测量表明了受试者报告内容的某些不一致性,而这些可以通过多种研究方法的混合使用得以克服。通过对数据的比较,推荐在将来的研究设计中使用阳性与阴性症状量表、针刺临床试验干预措施报告标准以及在问卷中增加对药物副作用、运动、睡眠以及日常作息的调查。在将来的研究中还应充分考虑到,恢复期患者容易复发,应该让他们可以方便地获得帮助。

Objective：This study explored the effects of individualized acupuncture when used alongside routine care for patients diagnosed with schizophrenia in order to assess the possibility and nature of potential benefits for this patient group. This study used an exploratory case study approach that included both quantitative and qualitative research tools,in order to generate a hypothesis questioning the possible benefits of acupuncture and develop future study designs. Methods：Eleven patients diagnosed with schizophrenia were given multiple validated quantitative and qualitative assessments before,during and after a 10-week acupuncture intervention. A range of qualitative and quantitative assessments were employed including review of acupuncture,general practitioner and mental health clinical case notes. Qualitative data were interrogated to explore the reliability of participants’ reports to researchers,their clinicians and their carers while acting as informants in the study.Results：Eight out of eleven participants completed a course of acupuncture treatment and all eleven reported positive benefits as a result of acupuncture,including improvements in the symptoms of schizophrenia,side effects of medication,energy,motivation,sleep,addictions and other associated physical problems. However,participants’ reports to the researcher and the acupuncturists varied at times and were often inconsistent between treatments,with participants revealing more information to the team towards the end of the study.Conclusion：The study indicates that patients diagnosed with schizophrenia would benefit from acupuncture treatment alongside conventional treatment. Triangulation of the data highlights some inconsistencies in reporting from participants,but also that this can be overcome through the use of mixed research methods. Comparison of data also shows that future studies would benefit from using a Positive and Negative Syndrome Scale,the Standards for Reporting Interventions in Controlled Trials of Acupuncture and an enhanced questionnaire regarding side effects of medication,exercise,sleep and daily routine. It is also worth noting that future studies of this nature must maintain consideration for the vulnerability of participants as they recover and make support easily accessible.