针刺改善抑郁症患者停药撤药反应及降低复发率的应用研究

Applied Research of Acupuncture Improving Withdrawal Reaction and Reducing Recurrence Rate in Patients with Depression

目的:观察针刺改善抑郁症患者停药撤药反应及降低复发率的效果,以提升抑郁症患者治疗质量。方法:选择我院收治的抑郁症患者80例作为研究对象,采用随机数字表法分为对照组和治疗组,每组各40例。两组患者均采用抗抑郁症药物盐酸氟西汀片(百忧解)治疗,同时予以抑郁症相关认知宣教,治疗组患者在此治疗基础上,再予以针刺穴位辅助治疗。两组患者均连续治疗8周,采用逐渐减量的方法停药,时间12个月,期间治疗组视情况给患者继续予以针灸辅助治疗。观察两组患者治疗前、完成治疗后3个月、6个月、12个月简单自测抑郁量表(PHQ-9)、汉密尔顿抑郁评分(HAMD)、PHQ-9变化;用药治疗期间药物不良反应情况、停药期间发生的撤药反应率;12个月停药时间内的停药成功率、治愈率、患者治疗期间服药依从性,观察两组患者1.5年后抑郁症复发率并比较。结果:两组患者完成治疗后3个月、6个月、12个月HAMD评分、PHQ-9较治疗前均明显下降,且治疗组评分明显低于对照组(P<0.05);治疗组患者12个月治疗期间药物不良反应率明显低于对照组(P<0.05);逐渐减量停药期间,治疗组撤药反应率明显低于对照组(P<0.05);12个月停药期后,治疗组患者3例停药不成功,对照组患者中8例停药不成功,治疗组患者停药成功率明显高于对照组(P<0.05)。两组患者完成12个月治疗后,治疗组痊愈率、总有效率明显高于对照组(P<0.05)。随访1.5年后,治疗组复发6人,明显低于对照组11人(P<0.05)。结论:针刺辅助治疗抑郁症患者可有效降低患者药物不良反应率、提升患者服药依从率、降低撤药反应率及复发率,是抑郁症患者治疗的有效辅助方法,具有较高的临床价值。

Objective： To observe the effect of acupuncture improving withdrawl reaction and reducing recurrence rate in patients with depression,thus to improve the quality of treatment for depression. Methods： 80 patients with depression were randomly divided into the control group（ n = 40） and the observation group（ n =40）. Both groups were treated with Fluoxetine Hydrochloride tablets（ Prozac）; meanwhile,knowlege about depression was informed in the patients. On which basis,the observation group was also treated with acupuncture.Two groups of patients were treated for 8 weeks,with a gradual reduction of withdrawal method,it took 12 months; during which,the observation group would be given acupuncture treatment if necessary. The changes of self-made PHQ-9,HAMD and PHQ-9 were observed before treatment,3 months,6 months and 12 months after treatment. Adverse reaction and withdrawal reaction were also observed. Withdrawal success rate,cure rate and medication compliance during the 12-month withdrawal period,as well as the recurrence rate of depression during one and a half year were compared between the two groups. Results： The scores of HAMD and PHQ-9 were significantly decreased 3 months,6 months and 12 months after treatment in both groups,in which the observation group decreased more than the control group（ P〈0. 05）. In terms of adverse reaction rate during 12 months of treatment,it was significantly lower in the observation group than that in the control group（ P〈0. 05）. In terms of withdrawal reaction rate during the period of gradual reduction and withdrawal,it was also significantly lower in the observation group than that in the control group（ P〈0. 05）. In terms of withdrawal success rate,it was greatly higher in the observation group（ 3 failed） than that of the control group（ 8 failed）（ P〈0. 05）. The cure rate and total effective rate of the observation group were significantly higher than those of the control group after 12 months of treatment（ P〈0. 05）. There were 6 recurrent cases in the observation group during the follow-up,which were obviously lower than 11 cases in the control group（ P〈0. 05）. Conclusion： Acupuncture as an adjuvant therapy can effectively reduce the rate of adverse reactions,improve medication compliance,and reduce the rates of drug withdrawal and recurrence in treatment of depression. It has a great clinical value.