调神止痛针法联合帕罗西汀治疗持续性躯体形式疼痛障碍的临床观察

Clinical Observation on Mind-Regulating and Pain-Relieving Acupuncture Therapy Combined with Paroxetine in Treating Persistent Somatoform Pain Disorder

【目的】观察调神止痛针法联合帕罗西汀治疗持续性躯体形式疼痛障碍的临床疗效。【方法】将96例持续性躯体形式疼痛障碍患者随机分为西药组、针刺组和针药结合组,每组各32例。西药组给予口服盐酸帕罗西汀片治疗,针刺组给予调神止痛针法治疗,针药结合组给予调神止痛针法联合帕罗西汀疗法治疗,连续治疗8周。治疗8周后,观察2组患者治疗前后视觉模拟量表(VAS)评分、症状自评量表(SCL-90)评分以及生活质量综合评定问卷(GQOLI-74)评分的变化情况,并评价2组患者的临床疗效。【结果】(1)研究过程中,西药组失访2例、针刺组失访3例,针药结合组失访1例。最终西药组30例、针刺组29例、针药结合组31例纳入疗效统计。(2)治疗后,3组患者的VAS评分明显改善(P<0.05),且针药结合组在改善VAS评分方面均明显优于西药组和针刺组,差异均有统计学意义(P<0.05)。(3)治疗后,3组患者的SCL-90各因子评分均明显改善(P<0.05),针药结合组在改善SCL-90各因子评分方面均明显优于西药组,差异均有统计学意义(P<0.05)。针药结合组在改善SCL-90各因子评分方面除人际关系因子之外,其余各因子评分均明显优于针刺组,差异均有统计学意义(P<0.05)。针药结合组在改善SCL-90人际关系因子方面,与针刺组比较,差异无统计学意义(P>0.05)。(4)治疗后,3组患者的GQOLI-74评分均明显改善(P<0.05),针药结合组在改善GQOLI-74评分方面均明显优于西药组,差异均有统计学意义(P<0.05)。针药结合组在改善GQOLI-74评分方面稍优于针刺组,但差异无统计学意义(P>0.05)。(5)针药结合组总有效率为90.32%(28/31),西药组为70.00%(21/30),针刺组为72.41%(21/29)。针药结合组疗效优于西药组和针刺组,差异均有统计学意义(P<0.05)。【结论】调神止痛针法联合帕罗西汀治疗持续性躯体形式疼痛障碍,能明显改善患者的临床症状,从而提高患者的生活质量,临床疗效显著。

Objective To observe the clinical effect of mind-regulating and pain-relieving acupuncture therapy combined with paroxetine for the treatment of persistent somatoform pain disorder.Methods Ninety-six patients with persistent somatoform pain disorder were randomly divided into western medicine group,acupuncture group and acupuncture drug combination group,32 cases in each group.The western medicine group received oral use of paroxetine hydrochloride tablets,acupuncture group received mind-regulating and pain-relieving acupuncture treatment,and acupuncture drug combination group received mind-regulating and pain-relieving acupuncture combined with oral use of paroxetine hydrochloride tablets.The treatment lasting 8 continuous weeks.After 8 weeks of treatment,the scores of Visual Analogue Scale(VAS),symptom Check-list 90(SCL-90)and Generic Quality of Life Inventor-74(GQOLI-74)were observed in the 3 groups before and after treatment,and the clinical efficacy was evaluated.Results(1)During the trial,2 cases from the western medicine group were lost to follow-up,3 cases from the acupuncture group,and one case from the acupuncture drug combination group.Finally,30 cases in western medicine group,29 cases in acupuncture group and 31 cases in acupuncture drug combination group were included into the curative effect statistics.(2)After treatment,the VAS scores of the 3 groups were significantly improved(P<0.05),and the improvement in VAS scores of the acupuncture drug combination group was superior to that of the western medicine group and acupuncture group,the differences being statistically significant(P<0.05).(3)After treatment,the various items of SCL-90 scores of the 3 groups were significantly improved(P<0.05),and the improvement in various items of SCL-90 scores of the acupuncture drug combination group was superior to that of the western medicine group,the differences being statistically significant(P<0.05).The improvement in scores of SCL-90 factors except for interpersonal relationship factor of the acupuncture drug combination group was superior to that of the acupuncture group,the differences being statistically significant(P<0.05).There were no significant differences in improving SCL-90 interpersonal relationship factor between acupuncture drug combination group and acupuncture group(P>0.05).(4)After treatment,the GQOLI-74 scores of the 3 groups were significantly improved(P<0.05),the improvement in GQOLI-74 scores of the acupuncture drug combination group was superior to that of the western medicine group,the differences being statistically significant(P<0.05),and the improvement in GQOLI-74 scores of the acupuncture drug combination group was superior to that of the acupuncture group,but the differences being statistically insignificant(P>0.05).(5)The total effective rate was 90.32%(28/31)in the acupuncture drug combination group,70.00%(21/30)in the western medicine group,and 72.41%(21/29)in the acupuncture group.The curative efficacy of the acupuncture drug combination group was superior to that of the western medicine group and acupuncture group(P<0.05).Conclusion Mind-regulating and pain-relieving acupuncture therapy combined with paroxetine is effective for improving clinical symptoms of patients with persistent somatoform pain disorder,thus to promote quality of life.