醒脑安神针刺法治疗躯体形式疼痛障碍疗效观察

Efficacy on somatoform pain disorder treated with resuscitation and tranquilization acupuncture technique

目的:比较醒脑安神针刺法与口服黛力新治疗躯体形式疼痛障碍的疗效差异。方法:将40例躯体形式疼痛患者(可合并轻中度抑郁)随机分为针刺组与西药组,每组20例。针刺组给予针刺神庭、水沟、四神聪透百会、风池等穴位,每日1次,每周6次;西药组给予口服抗抑郁药物黛力新,每日早晨及中午各1片。两组均连续治疗8周后,采用划线法疼痛指数(VAS)和汉密尔顿抑郁量表(HAMD)评分评定两组患者的疗效,观察其不良反应,3个月后随访其复发率。结果:两组患者治疗后VAS评分和HAMD评分均较治疗前明显降低(均P<0.05);针刺组VAS评分下降的幅度显著大于西药组(P<0.05),HAMD评分下降的幅度与西药组比较差异无统计学意义(P>0.05);针刺组无不良反应发生,西药组有3例出现头晕、震颤、口干、便秘等不良反应;针刺组愈显率为50.0%(10/20),优于西药组的15.0%(3/20,P<0.05);针刺组复发率为10.0%(2/20),低于西药组35.0%(7/20,P<0.05)。结论:醒脑安神针刺法治疗躯体形式疼痛障碍疗效确切,能够改善病人的抑郁症状,尤其在缓解疼痛、减少不良反应及降低复发率方面优于西药黛力新。

Objective To compare the efficacy differences in the treatment of somatoform pain disorder between resuscitation and tranquilization acupuncture technique and oral administration of deanxit. Methods Forty cases of somatoform pain disorder （complicated with mild and moderate depression） were randomized into an acupuncture group and a western medication group, 20 cases in each one. In the acupuncture group, acupuncture was applied to Shenting （GV 24）, Shuigou （GV 26）, Sishencong （EX-HN 1） to Baihui （GV 20） （penetrating technique）, Fengehi （GB 20）, etc. The treatment was given once every day, 6 times a week. In the western medication group, the anti-depression drug, deanxit was prescribed for oral administration, 1 tablet in every morning and lunehtime each day. In 8 weeks of continuous treatment, the visual analogue scale （VAS） and Hamilton depression scale-17 items （HAMD） were used to evaluate the efficacy in the patients of the two groups, the adverse reactions were observed and the recurrence rate was followed up in 3 months. Results After treatment, VAS and HAMD scores were all apparently reduced as compared with those before treatment in the patients of the two groups （all P〈0.05）. The reducing amplitude of VAS score in the acupuncture group was greater than that in the western medication group （P〈0.05） and that of HAMD score was not different significantly as compared with that in the western medica- tion group （P〉0.05）. There was no adverse reaction in the acupuncture group and were 3 cases as dizziness, trembling, dry mouth and constipation in the western medication group. The curative and remarkably effective rate was 50.0% （10/20） in the acupuncture group, better than 15.0% （3/20） in the western medication group （P〈0.05）. The recurrence rate was 10. 0% （2/20） in the acupuncture group, lower than 35. 0% （7/20） in the western medication group （P〈0. 05）. Conclusion The resuscitation and tranquilization acupuncture technique achieves the definite efficacy on somatoform pain disorder, relieves depression symptoms of patients, especially pain and reduces adverse reactions and recurrence rate. The effects of this therapy are advanced as compared with deanxit.