针刺治疗难治性抑郁症增效作用的对照研究

A Control Study of Synergistic Effect of Acupuncture for Treatment-refractory Depression

目的:观察针刺治疗作为难治性抑郁症增效治疗方法的临床疗效和安全性。方法:将60例诊断为难治性抑郁症的患者随机分为2组各30例。对照组单纯采用足量抗抑郁药物治疗;观察组在对照组治疗的基础上加用针刺治疗。2组均治疗14周评价疗效。采用汉密尔顿抑郁量表(HAMD)于治疗前及治疗后第1、2、4、6、10及14周末评价2组临床疗效。采用不良反应量表(TESS)于治疗前及治疗后第1、2、4、6、10和14周末评价2组安全性。结果:2组患者治疗后HAMD评分较治疗前均有下降,观察组第1、2、4、6、10、14周末与治疗前比较,差异有显著性或非常显著性意义(P<0.05,P<0.01)。2组各时点HAMD评分比较,差异有显著性或非常显著性意义(P<0.05,P<0.01)。2组临床总有效率比较,差异有显著性意义(P<0.05)。2组不良反应发生率比较,差异无显著性意义(P>0.05),且均为轻度不良反应。结论:针刺治疗可作为难治性抑郁症的增效策略,具有疗效肯定和安全性高的特点,可作为抗抑郁增效剂的替代疗法,具有一定实用性,值得临床上推广应用。

Objective： To evaluate the safety and efficacy of acupuncture augmented with selective serotonin reuptake inhibitor（SSRI） for the treatment of treatment-refractory depression（TRD）. Methods. Sixty TRD patients were randomly divided into study group and control group, 30 cases in each group. Patients of the study group were treated by acupuncture combined with SSRI, but cases of the control group were treated only with SSRI for 14 weeks. They were assessed with Hamilton Depressive Scale（HAMD） and Treatment Emergent Symptom Scale（TESS） at the baseline and on 1st, 2nd, 4th, 6th, lOth, 14th weekend after treatment. Results._ The score of HAMD was decreased in both groups after treatment, and the decrease was obvious with the prolongation of treatment period. HAMD score in the study group at 1st post-treatment weekend differed from that before treatment （P 〈0.05）, and the difference was significant between the study group and the control group at various time point（P〈O.05 or P〈O.01）. The effective rate was higher in the study group than that in the control group（76.7% VS 56.7%） on the 14th weekend after treatment （P〈0.05）. The adverse reaction was mild in both groups, and the difference was insignificant（P〉0.05）.Conclusion： It is indicated that acupuncture combined with antidepressant medication has good efficacy and is safe for the treatment of TRD.