壮医药线点灸治疗抑郁症方案优选研究

Research on optimization scheme of medicated thread moxibustion of Zhuang medicine in treating depression

目的:观察壮医药线点灸所用不同的药线(浸泡药线的方药是否含麝香)和点灸手法的轻重对抑郁症的临床疗效及安全性的影响。方法:选择100例抑郁症患者随机分为5组,每组20例。观察组1选用含麝香的传统药方浸泡的药线,用轻手法治疗;观察组2选用含麝香的传统药方浸泡的药线,用重手法治疗;观察组3选用不含麝香的传统药方浸泡的药线,用轻手法治疗;观察组4选用不含麝香的传统药方浸泡的药线,用重手法治疗;西药对照组口服百忧解胶囊,疗程6周。观察治疗前后患者汉密尔顿抑郁量表(HAMD-17项)、抑郁自评量表(SDS)、临床疗效总评量表(CGI)评分变化,以HAMD-17减分率为主要疗效指标进行临床疗效评价。并进行安全性指标评价。结果:治疗后各组HAMD-17项、SDS、CGI评分与治疗前比较均显著减少(P<0.01,P<0.05);观察组1-4组及西药对照组总有效率依次为90.0%、85.0%、90.0%、85.0%、95.0%,5组比较差异无统计学意义;HAMD-17项评分变化比较,治疗第2、4周观察组1与观察组2、观察组3、观察组4之间比较均有显著差异(P<0.01,P<0.05);安全性评价,观察组1、观察组3没有发生任何不良反应,观察组2不良反应率为40%,观察组4不良反应率为45%,西药对照组不良反应率50%,观察组1、观察组3不良反应率与观察组2、观察组4、西药对照组比较差异均有统计学意义(P<0.01)。结论:壮医药线点灸选用含麝香传统药方浸泡的药线,并用轻手法点灸治疗抑郁症起效更快、更安全,患者依从性更好。

Objective： To study the effects of different threads（soaked in musk solution or not） and manipulation of moxibustion（heavy or gentle） of Zhuang medicine on the clinical efficacy and safety of depression treatment. Methods： One hundred cases of depression patients were included and divided into five groups（A, B, C, D and E） with 20 cases in each group respectively, first four groups were observation groups while group E was the control group. Group A accepted the treatment with musk threads and gentle manipulation; group B accepted the treatment with musk threads and heavy manipulation; group C accepted the treatment with non-musk threads and gentle manipulation; group D accepted the treatment with non-musk threads and heavy manipulation; group E accepted the treatment with oral Prozac Capsules. All the patients were treated for six weeks. The value of Hamilton＇s Depression Scale（HAMD-17） was taken as the major efficacy index to evaluate the clinical efficacy and safety before and after the treatment, along with Self-Rating Depression Scale（SDS） and Clinical Global Impression（CGI）.Results： The value of HAMD-17, SDS as well as CGI were significantly reduced after six-weeks anti-depression treatment in five groups（P〈0.01, P〈0.05）. The total effective rate of five groups were 90.0%, 85.0%, 90.0%, 85.0% and 95.0% respectively, and there was no statistical significance among those five groups. As to the value of HAMD-17, there was significant difference between group A and group B, C, D in the second and the fourth week（P〈0.01, P〈0.05） respectively. As to the safety valuation, there was no adverse reaction in group A and C, while the adverse reaction ratio of group B, D and E was 40%, 45% and 50% respectively; moreover, there was statistical significance in the adverse reaction ratio between group A, C and group B, D, E（P〈0.01）. Conclusion： Using medicated thread moxibustion of Zhuang medicine with musk threads and gentle manipulation was the better and safer treatment for depression.