穴位针刺联合氢溴酸西酞普兰治疗复发性抑郁症的对照研究

Contral study of acupuncture at Jiaohui acupoint combined with citalopram in the treatment of recurrent depression

目的探讨针刺交会穴联合氢溴酸西酞普兰治疗复发性抑郁症的临床疗效。方法将90例复发性抑郁症患者随机分为研究组和对照组各45例,研究组用针刺交会穴联合氢溴酸西酞普兰治疗,对照组只服用氢溴酸西酞普兰治疗,观察6周。在治疗前及治疗后第1、2、4、6周末用汉密顿抑郁量表(HAMD)评定疗效,用治疗中需处理的不良反应症状量表(TESS)评定不良反应,治疗结束后一年以临床总体印象量表-疗效总评(CGI-GI)计算复发率。结果治疗后第6周末,总体有效率在研究组(95.6%)及对照组(91.1%)之间无显著性差异(χ2=0.71,P>0.05);研究组显效率(80.0%)显著高于对照组(51.1%)(χ2=7.44,P<0.01)。研究组HAMD评分自第1周末起显著低于对照组(P<0.05,P<0.01);研究组HAMD评分自第2周末起显著低于治疗前(P<0.05,P<0.01),对照组HAMD评分自第4周末起显著低于治疗前(P<0.05,P<0.01)。研究组治疗后第1、2、4、6周末TESS量表总分显著低于对照组(P<0.01)。两组治疗结束后1年HAMD及CGI-GI评分比较,研究组显著低于对照组(P<0.05,P<0.01);研究组1年复发率(4.44%)显著低于对照组(20.0%)(χ2=4.94,P<0.05)。结论针刺交会穴联合氢溴酸西酞普兰治疗抑郁症起效快,副作用少,复发率低,值得推广。

Objective To study the clinical efficacy of acupuncture at Jiaohui acupoint combined with citalopram in the treatment of recurrent depression.Methods 90 patients with recurrent depression were randomized into stduy group （45 cases） treated with acupuncture at Jiaohui acupoint combined with citalopram for 6 weeks and control group （45 cases） treated with citalopram monotherapy for 6 weeks.Effects and side effects were evaluated with HAMD and TESS respectively at baseline and at the end of the 1st,2nd,4th,6th week of the treatment.CGI-GI was used to evaluate the relapse rate 1 year after the treatment.Results At the end of the 6-week treatment,there was no significant difference in total effective rate between study group and control group （95.6% vs.91.1%,x2 =0.71,P 〉0.05）,but the marked effective rate was significantly higher in study group than that in control group （80.0% vs.51.1%,x2 =7.44,P 〈 0.01）.Score of HAMD in study group was significantly lower than that in control group from the end of the 1st week （P 〈0.05 or P 〈0.01）.Compared with the baseline,score of HAMD in study group decreased significantly from the end of the 2nd week （P 〈 0.05 or P 〈 0.01）,while in control group the significant decrease appeared from the end of the 4th week of the treatment （P 〈 0.05 or P 〈 0.01）.Scores of TESS in study group were significantly lower than those in control group at the end of the 1st,2nd,4th,6th week of the treatment （P 〈0.01）.Scores of HAMD and CGI-GI in study group were significantly lower than those in control group at 1 year after the treatment （P 〈 0.01,P 〈0.05 respectively）.The 1-year relapse rate in study group was significantly lower than that in control group （4.44% vs.20.0%,x2 =4.94,P 〈 0.05）.Conclusion Acupuncture at Jiaohui acupoint combined with citalopram takes effect rapidly in the treatmen of depression and has little side effects,as well as low relapse rate.It is worthy of clinical popularization.