通督调神针法联合西药治疗慢性疼痛所致抑郁随机平行对照研究

Randomized Parallel Controlled Study on Dredging the Du Meridian and Regulating the Spirit Acupuncture Combined with Western Medicine for Chronic Pain-Induced Depression

[目的]观察通督调神针法联合西药治疗慢性疼痛所致抑郁疗效。[方法]使用随机平行对照方法,将109例门诊患者按就诊顺序号方法随机分为两组。对照组54例中度抑郁:氟哌噻吨美利曲辛,2片/次,早晨、中午饭后服用;重度抑郁:氟西汀,起始剂量20mg/d,早餐后顿服,根据病情调整剂量,≤40mg/d;奥氮平起始剂量2. 5mg/d,随病情调整,≤5mg/d。治疗组55例通督调神针法,取百会、四神聪、神庭、印堂、人中、内关、神门、太冲,百会、四神聪:小幅度、高频率捻转补法;神庭、印堂:小幅高频捻转;人中向鼻中隔方向斜刺0. 3~0. 5寸,重雀啄法,至眼球湿润或流泪为度;太冲,捻转提插泻法,针刺得气后均留针30min,5次/周;西药治疗同对照组。连续治疗2个月为1疗程。观测临床表现、抑郁自评量表(Self-rating depression scale,SDS)评分、24项汉密顿抑郁量表(Hamilton Depression Scale,HAMD)评分、不良反应。治疗1疗程(2个月),判定疗效。[结果]治疗组临床痊愈28例,显效14例,有效11例,无效2例,总有效率96. 367%;对照组临床痊愈21例,显效18例,有效9例,无效8例,总有效率85. 15%;治疗组疗效优于对照组(P <0. 05)。SDS评分、HAMD评分两组均有改善(P <0. 01),治疗组改善优于对照组(P <0. 01)。[结论]通督调神针法联合西药治疗慢性疼痛所致抑郁,疗效满意,无严重不良反应,值得推广。

[Objective]To observe the curative effect of dredging the Du meridian and regulating the spiritacupuncture combined with western medicine on depression caused by chronic pain.[Method]A total of 109 outpatients were randomly divided into two groups according to the order number of visits by randomized parallel control method. In the control group( 54 cases),moderate depression cases were given deanxit,2 tablets per time,taking in the morning and after lunch. The severe depression cases were given fluoxetine,starting dose 20 mg/d,after breakfast,adjusting the dose according to the condition(< 40 mg/d). The olanzapine initial dose was 2. 5 mg/d,adjusting according to the condition(< 5 mg/d). In the treatment group,55 cases were treated with dredging the Du meridian and regulating the spirit Acupuncture,taking Baihui( DU20),Sishenzhong( EX-HN1),Shenting( DU24),Yintang( EX-HN3),Renzhong( DU26),Neiguan( PC6),Shenmen( HT7) and Taichong( LR3). Baihui( DU20) and Sishenzhong( EX-HN1) were given acupuncture by small amplitude and high frequency twisting patching method. Shenting( DU24) and Yintang( EX-HN3) used small high frequency twisting method. Renzhong( DU26) was obliquelyacupuncture 0. 3-0. 5 inches towards nasal septum by heavy sparrow pecking method until wetness or tearing of the eyeball. Taichong( LR3) was needled by twisting,lifting and catharsis method. All the needles were retained for 30 min after Qi obtaining,5 times a week. The western medicine treatment was the same as the control group. Two months was a course of treatment. Clinical manifestations,self-rating depression scale( SDS),24 items of hamilton depression scale( HAMD) and adverse reactions were observed. After one course of treatment( 2 months),we determined the curative effect.[Result]In the treatment group,28 cases were cured,14 cases were markedly effective,11 cases were effective and 2 cases were ineffective and the total effective rate was 96. 367%. In the control group,21 cases were cured,18 cases were markedly effective,9 cases were effective and 8 cases were ineffective and the total effective rate was 85. 15%. The curative effect of the treatment group was better than that of the control group( P < 0. 05). SDS score and HAMD score were improved in both groups( P < 0. 01),and the improvement in treatment group was better than that in control group( P < 0. 01).[Conclusion]dredging the Du meridian and regulating the spiritacupuncture combined with western medicine has satisfactory curative effect on depression caused by chronic painand has no serious adverse reactions,which is worthy of promotion.