调神通络针法联合电针及重复经颅磁刺激治疗老年抑郁症36例临床观察

Clinical Observation on Regulating-Spirit Freeing-Vessels Acupuncture,Electro-Acupuncture and Repetitive Transcranial Magnetic Stimulation for 36 Cases of Geriatric Depression

目的观察调神通络针法联合电针及重复经颅磁刺激治疗老年抑郁症的临床疗效及安全性。方法将72例老年抑郁症患者随机分为对照组和治疗组各36例,电针及重复经颅磁刺激作为基础治疗,对照组在基础治疗的同时给予口服盐酸氟西汀胶囊20mg,每日1次;治疗组在基础治疗的同时给予调神通络针法治疗,两组均治疗8周后判定临床疗效。于治疗前及治疗后2、4、6、8周分别记录两组患者24项汉密尔顿抑郁量表(HAMD-24)积分,治疗中观察不良反应,并对安全性进行分级。结果治疗组临床疗效总有效率72.22%,对照组为63.89%,两组比较差异无统计学意义(P>0.05)。HAMD-24焦虑因子积分:与本组治疗前比较,治疗组治疗后第2、4、6、8周积分明显降低(P<0.05);对照组治疗后第4、6、8周积分明显降低(P<0.05);两组治疗后第2、4、6、8周比较,治疗组明显低于对照组(P<0.05)。HAMD-24睡眠障碍因子积分:与本组治疗前比较,治疗组治疗后第4、6、8周积分明显降低(P<0.05);对照组第6、8周积分明显降低(P<0.05);两组治疗后4、8周比较治疗组明显低于对照组(P<0.05)。两组均无明显不良反应,且两组安全性级别比较差异无统计学意义(P>0.05)。结论调神通络针法联合电针及重复经颅磁刺激是治疗老年抑郁症有效、安全的方法,对改善焦虑及睡眠障碍疗效优于盐酸氟西汀。

Objective To observe the efficacy of regulating-spirit freeing-vessels acupuncture, electro-acupuncture （EA） and repetitive transcranial magnetic stimulation （rTMS） for geriatric depression. Methods Totally 72 cases of geriatric depression were randomized into the treatment group and control group, with 36 in each. Both groups were given EA and rTMS as the basic treatment. The patients in the control group were orally taken 20 mg of fluoxetine hydrochloride capsules once daily. The treatment group was added with regulating-spirit freeing-vessels acu- puncture. Both groups were treated for 8 weeks. The scores of Hamilton Depression Scale were recorded before treatment and in the 2nd, 4th, 6th and 8th week after treatment. The efficacy was evaluated. Results The total effective rate of the treatment group and control group were 72.22% and 63.89% respectively, with no significant difference between groups （P 〉 0.05）. The anxiety factor scores were significantly decreased in the 2nd, 4th, 6th and 8th week after treatment in the treatment group （P 〈 0.05 ） and significantly decreased in the 4th, 6th and 8th week after treatment in the control group （ P 〈 0. 05 ）, with a significant difference between groups in the 2nd, 4th, 6th and 8th week （ P 〈 0. 05 ）. The scores of sleep disorders factor were significantly decreased in the 4th, 6th and 8th week after treatment in the treatment group （ P 〈 0. 05 ） and significantly decreased in the 6th and 8th week after treatment in the control group （ P 〈 0.05 ）, with a significant difference between groups in the 4th and 8th week （ P 〈 0. 05）. Conclusion The combo therapy of regulating-spirit freeing-vessels acupuncture, EA and rTMS is effective and safe for geriatric depression and it can obviously relieve anxiety and sleep disorders.