肝经五输穴针刺放血治疗抑郁症的疗效及对血液流变学的影响

Observation on Therapeutic Effect of Acupuncture of Five Shu-points of the Liver Meridian Combined with Bloodletting for Depression Patients and Concomitant Changes of Blood Rheology

目的:观察肝经五输穴针刺放血治疗抑郁症的临床疗效,探讨抑郁症患者血液流变学变化与疗效的相关性。方法:将30例抑郁症患者随机分为两组,其中药物组15例,仅单纯给予药物氟西汀治疗;针刺组15例,采用肝经五输穴针刺放血治疗。在治疗前、治疗后第1、2、4、6、8周末分别用汉密尔顿抑郁量表、临床总体印象量表(CGI-SI)来评定临床疗效;治疗前及治疗结束后对两组患者进行血液流变学指标的检测。结果:两组患者的显效率差异无统计学意义(P>0.05),但治疗第6、8周CGI-SI改善方面,针刺组优于药物组(P<0.05);治疗结束后两组患者的全血高切黏度、全血低切黏度、红细胞聚集指数、纤维蛋白原等明显低于治疗前(P<0.05),但两组之间差异无统计学意义(P>0.05)。结论:肝经五输穴针刺放血治疗抑郁症的疗效确切,治疗第6周以后症状改善明显;血液流变学一定程度上反映病情变化。

Objective To observe the clinical efficacy of acupuncture of five Shu-points of the Liver Meridian plus bloodletting for depression patients and its effect on hemorheology.Methods Thirty depression outpatients were randomly and equally divided into medication and acupuncture＋bloodletting groups.Patients of the medication group were treated with Fluoxetine（20 mg/d,PO.in the morning） and those of the acupuncture＋bloodletting group treated by acupuncture of Xingjian（LR 2）,Taichong（LR 3）,Zhongfeng（LR 4） and Ququan（LR 5） first,followed by pricking Dadun（LR 1） to let a little bit of blood out.The treatment was given once every other day,two months altogether.The therapeutic effect was assessed by using Hamilton Depression Rating Scale（HAMD） and the Clinical Global Impression Scale for Severity of Illness（CGI-SI） before and 1,2,4,6,and 8 weeks after the treatment,respectively.Changes of hemorheology were detected by using a blood rheology detector.Results Of the 15 outpatients in both medication and acupuncture＋bloodletting groups,6（40.00%）and 6（40.00%）were cured basically,5（33.34%） and 4（26.67%） experienced marked improvement,2（13.33%）and 3（20.00%）were improved,and 2（13.33%） and 2（13.33%）invalid,respectively.No significant difference was found between the two groups in the therapeutic effect（P0.05）.On the 6th and 8th weeks of the treatment,the CGI-SI score of the acupuncture＋bloodletting group was significantly lower than that of the medication group（P0.05）,suggesting a better therapeutic effect of the acupuncture＋bloodletting group.The low and high shear viscosity of whole blood,erythrocyte aggregation index and rigidity index,and fibrinogen levels of the two groups were decreased significantly after the treatment（P0.05）.No significant difference was found between the two groups in the changes of hemorheology indexes following the treatment（P0.05）.Conclusion Acupuncture of the five Shu-points of the Liver Meridian combined with bloodletting is effective in relieving depression symptoms and improving blood rheology in depression patients.