针刺联合经颅微电流刺激治疗广泛性焦虑症:随机对照研究

Acupuncture combined with cranial electrotherapy stimulation on generalized anxiety disorder: a randomized controlled trial

目的:观察针刺联合经颅微电流刺激疗法(CES)治疗广泛性焦虑症的临床疗效。方法:将200例广泛性焦虑症患者随机分为针刺+CES组、针刺组、CES组及药物组,每组50例。药物组采用口服枸橼酸坦度螺酮片治疗,每日早、中、晚饭后各10 mg;CES组采用SCS脑部电医学治疗仪行CES治疗,每次60 min,每日1次;针刺组针刺百会、四神聪、印堂、神庭等穴,每日1次,每次30 min;针刺+CES组先予CES再予针刺治疗,4组均治疗60d。观察4组患者治疗前后汉密尔顿焦虑量表(HAMA)、世界卫生组织生存质量测定量表简表(WHOQOL-BREF)及不良反应症状量表(TESS)评分变化,评定临床疗效,并于1年随访时记录4组焦虑复发情况。结果:治疗后,4组患者HAMA评分均较治疗前降低、WHOQOL-BREF评分均较治疗前升高(P<0.05),且针刺+CES组患者HAMA、WHOQOL-BREF评分改善幅度均大于其他3组(P<0.05)。药物组患者治疗后TESS评分及随访1年复发率均明显高于其他3组(P<0.05)。针刺+CES组总有效率高于其他3组(P<0.05)。结论:针刺联合CES能有效缓解广泛性焦虑症患者的症状,提高患者的生存质量,减少不良反应的发生,降低复发率,疗效优于西药、单纯针刺及单纯CES。

Objective To observe the therapeutic effect of acupuncture combined with cranial electrotherapy stimulation(CES) on generalized anxiety disorder(GAD). Methods A total of 200 patients with GAD were randomized into an acupuncture+CES group, an acupuncture group, a CES group and a medication group, 50 cases in each one. In the medication group, patients were treated with tandospirone citrate tablet orally, 10 mg after breakfast, lunch and dinner respectively. In the CES group, CES was adopted by SCS brain electromedical instrument, 60 min each time, once a day. In the acupuncture group, acupuncture was applied to Baihui(GV 20), Sishencong(EX-HN 1), Yintang(GV 29), Shenting(GV 24), etc., 30 min each time, once a day. In the acupuncture+CES group, CES was adopted before acupuncture. Treatment of sixty days was required in the 4 groups. Before and after treatment, the scores of Hamilton anxiety scale(HAMA), World Health Organization’s quality of life questionnaire-brief version(WHOQOL-BREF) and treatment emergent symptom scale(TESS) were observed, the clinical effect was evaluated, and the relapse of anxiety during follow-up of 1 year after treatment was recorded in the 4 groups.Results Compared before treatment, the scores of HAMA after treatment were decreased(P<0.05), the scores of WHOQOLBREF after treatment were increased in the 4 groups(P<0.05), and the improvements of above scores in the acupuncture+CES group were greater than the other 3 groups(P<0.05). The score of TESS after treatment and the relapse rate of 1-year follow-up in the medication group were higher than those in the other 3 groups(P<0.05). The total effective rate in the acupuncture+CES group were superior to the other 3 groups(P<0.05). Conclusion Acupuncture combined with CES can effectively relieve the symptoms in patients with GAD, improve the quality of life, reduce the occurrence of adverse reactions and the relapse rate, and its clinical effect is obviously superior to the western medication, the simple application of acupuncture or CES.