隔姜灸联合西药治疗阳虚型抑郁症的临床研究

Clinical study on depression differentiated as yangdeficiency treated with the combined therapy of ginger-isolated moxibustion and western medicine

目的:比较隔姜灸联合草酸艾司西酞普兰与单纯草酸艾司西酞普兰治疗阳虚型抑郁症的临床疗效差异。方法:将80例阳虚型抑郁症患者随机分为观察组与对照组,每组40例。对照组口服草酸艾司西酞普兰,每日10mg,早餐后顿服。观察组在对照组治疗基础上联用隔姜灸治疗,穴取大椎穴、双侧五脏背俞穴(心俞、肝俞、脾俞、肺俞、肾俞),一周灸5次,20次为一疗程,共治3个疗程(共84d)。治疗3个疗程后,观察两组患者治疗前后血清5-羟色胺(5-HT)浓度水平及临床疗效。3个疗程后两组患者继续予草酸艾司西酞普兰(10mg/日)维持治疗9个月,观察两组停药半年内的复发率。结果:观察组总有效率为97.5%(39/40),对照组为92.5%(37/40),两组总有效率相当(P>0.05);观察组愈显率为82.5%(33/40),优于对照组的62.5%(25/40,P<0.05);两组患者治疗后血清5-HT均较治疗前增加(均P<0.05),两组间比较差异无统计学意义(P>0.05);观察组复发率为7.7%(3/39),低于对照组的27.0%(10/37,P<0.05)。结论:隔姜灸联用草酸艾司西酞普兰治疗阳虚型抑郁症患者在愈显率方面优于单纯西药组,可显著减少抑郁症的复发。

Objective To compare the differences in the clinical efficacy on depression differentiated as yang deficiency between the combined therapy of ginger-isolated moxibustion and escitalopram and the simple application escitalopram.Methods Eighty patients of depression differentiated as yangdeficiency were randomized into an observation group and a control group,40 cases in each one.In the control group,escitalopram was prescribed for oral administration,10 mg a day,after each breakfast.In the observation group,on the basis of the treatment as the control group,the ginger-isolated moxibustion was supplemented at Dazhui(GV 14)and bilateral back-shupoints of five zangorgans[Xinshu(BL 15),Ganshu(BL 18),Pishu(BL 20),Feishu(BL 13)and Shenshu(BL 23)].Moxibustion was used 5times a week.Twenty times of moxibustion were taken as one session and totally 3sessions were required(totally 84days).After 3sessions of treatment,the concentration of serum 5-hydroxytryptamine(5-HT)before and after treatment and clinical efficacy were observed in the two groups.After 3sessions of treatment,escitalopram was taken continuously,10 mg a day for 9months in the two groups and the recurrent rate was observed in a half year after discontinuity of medication in the two groups.Results The total effective rate was 97.5%(39/40)in the observation group and was 92.5%(37/40)in the control group.The total effective rate was similar between the two groups(both P>0.05).The curative and remarkably effective rate was 82.5%(33/40)in the observation group,better than 62.5%(25/40)in the control group(P<0.05).The serum 5-HT after treatment was increased as compared with that before treatment in the patients of the two groups(both P<0.05),but the difference was not significant statistically between the two groups(P>0.05).The recurrent rate of depression was7.7%(3/39)in the observation group,lower than 27.0%(10/37)in the control group(P<0.05).Conclusion The combined therapy of ginger-isolated moxibustion and escitalopram achieves the better curative and remarkably effective rate as compared with the simple western medicine and it significantly reduces the recurrence of depression.