腹部推拿治疗广泛性焦虑症的疗效观察

The clinical efficacy of abdominal massage and its possible mechanism in the treatment of generalized anxiety disorder

目的：观察腹部推拿治疗广泛性焦虑症（GDA）的临床疗效，并对其可能机制进行初步探索。方法将126例 GDA 患者按数字表法随机分为腹部推拿组和西药治疗组，每组各63例。两组治疗15 d 为1个疗程，治疗2个疗程。观察两组汉密顿焦虑量表（HAMA）评分、焦虑（SAS）评分、5-羟色胺（5-HT）水平及总体治疗效果等级。结果治疗后两组身体性焦虑评分、精神性焦虑评分、SAS 总分、HAMA 评分、5-HT 水平均呈明显的下降趋势，与治疗前比较[推拿组：（9．44±3．12）分、（12．04±3.97）分、（53．16±6．25）分、（37.49±10．08）分、（315．26±25．33）ng／mL；西药组：（9．15±3．59）分、（12．71±4．55）分、（54．69±5．19）分、（36．35±10．14）分、（314．22±31．29）ng／mL]，差异均有统计学意义（推拿组 t 值分别为：11．839、12．037、38.769、12．696、37．010，P 值分别为：0．000、0．000、0．000、0．000、0．000；西药组 t 值分别为：9．638、12．056、43.947、13．459、29．997，P 值分别为：0．000、0．000、0．000、0．000、0．000）；但治疗前、治疗后，两组差异均无统计学意义（治疗前：t 值分别为：0．484、0．629、－0．881，P 值分别为：0．629、0．380、0．138；西药组 t 值分别为：－0．778、0．577、1．907，P 值分别为：0．438、0．565、0．000）。腹部推拿组和西药组的有效率分别为93．65％和95.24％，差异无统计学意义（χ^2＝0．151，P ＝0．697）。结论腹部推拿是一种安全可靠、经济有效的治疗广泛性焦虑症的手段，可能与机体的5-HT 水平的降低有一定的关系。

Objective To investigate the clinical outcomes of abdominal massage in the treatment of general-ized anxiety disorder （GDA ）,and to carry out preliminary exploration of its possible mechanism.Methods 126 patients were randomized to receive GDA abdominal massage and medicine treatment.Hamilton Anxiety Scale （HAMA）score,anxiety （SAS）score,serotonin （5 -HT）levels and overall treatment effect level were observed. Results After treatment,body anxiety score,psychic anxiety score,SAS score,HAMA score,5 -HT levels in two groups showed clear downward trend compared with before treatment [abdominal massage group：（9.44 ± 3.12）points,（12.04 ±3.97）points,（53.16 ±6.25）points,（37.49 ±10.08）points,（315.26 ±25.33）points;med-icine treatment group：（9.15 ±3.59）points,（12.71 ±4.55）points,（54.69 ±5.19）points,（36.35 ±10.14）points, （314.22 ±31.29）points],the differences were statistically significant （the massage group：t =11.839,12.037, 38.769,12.696,37.010,P =0.000,0.000,0.000,0.000,0.000;medicine group：t =9.638,12.056,43.947, 13.459,29.997,P =0.000,0.000,0.000,0.000,0.000）.But before treatment,after treatment,differences between the two groups were not statistically significant （before treatment：t =0.484,0.629,-0.881,P =0.629,0.380, 0.138;after treatment：t =-0.778,0.577,1.907,P =0.438,0.565,0.000）.The effective rates of abdominal mas-sage group and western medicine group were 93.65% and 95.24% respectively,the difference was not statistically significant （χ^2 =0.151,P =0.697）.Conclusion Abdominal massage is a safe,reliable and effective means of treat-ment of GDA and may have some relationship with decreased 5 -HT levels in the body.