颅骨缝针刺法联合帕罗西汀治疗抑郁症患者的疗效观察

Observation on the Curative Effect of Skull Suture Acupuncture Combined with Paroxetine in the Treatment of Patients with Depression

目的通过颅骨缝针刺法联合帕罗西汀治疗抑郁症,并与单纯帕罗西汀治疗作比较,以期观察颅骨缝针刺法的临床疗效及安全性,并阐述其治疗机制。方法选取2016年8月—2017年6月期间十堰市太和医院神经内科门诊或住院的符合抑郁症诊断标准的患者100例,按入院先后顺序进行排号,并按随机数字表法随机分成治疗组与对照组,每组各50例。对照组患者单用帕罗西汀片治疗,治疗组患者在对照组基础上同时给予颅骨缝针刺法进行治疗。两组均连续治疗6周。采用汉密尔顿抑郁量表(HAMD-17)分别于治疗前及治疗第1、2、4、6周后进行评分,并观察临床疗效及安全性。结果治疗后治疗组总有效率为94.0%(47/50),对照组总有效率为78.0%(39/50),两组比较,差异有统计学意义(P=0.000<0.01,χ2=30.587)。对照组患者治疗第2、4、6周后HAMD评分较治疗前降低,差异有统计学意义(P<0.05),治疗组患者治疗第1、2、4、6周后HAMD评分较治疗前降低,差异有统计学意义(P<0.05),且治疗组治疗第4、6周后HAMD评分结果优于对照组,两组比较差异有统计学意义(P<0.05)。两组患者不良反应发生率:治疗组出现恶心呕吐、腹胀1例,口干口苦、头昏1例;对照组出现恶心呕吐、腹胀4例,心率增快者1例,口干口苦、头昏1例,两组患者经对症治疗后,部分症状逐渐缓解,且随治疗周期的延长,不良反应症状逐渐消失。治疗组的不良反应发生率小于对照组,所有患者均按要求完成了治疗方案,无脱落病例。结论颅骨缝针刺法治疗抑郁症临床疗效较佳,可有效降低抑郁症患者汉密尔顿抑郁量表(HAMD)评分,且起效时间快,并能减轻药物副反应,值得临床推广。

Objective To treat depression with skull suture acupuncture combined with drug paroxetine,and compare with the drug paroxetine alone,in order to observe the clinical efficacy and safety of skull suture acupuncture and explain its treatment mechanism.Methods A total of 100 patients who met the diagnostic criteria for depression in the Department of Neurology of Taihe Hospital of Shiyan City from August 2016 to June 2017 were selected.They were ranked according to the order of admission and randomly divided into treatments according to the random number table.Group and control group,50 cases in each group.Patients in the control group were treated with paroxetine tablets alone,and patients in the treatment group were treated with skull suture acupuncture on the basis of the control group.The treatment was continued for 6 weeks,and the Hamilton Depression Scale(HAMD-17)was used to evaluate the results before treatment and after 1,2,4,and 6 weeks of treatment to observe the clinical efficacy and safety.Results After treatment,the total effective rate in the treatment group was 94.0%(47/50),and the total effective rate in the control group was 78.0%(39/50).The difference between the two groups was statistically significant(P=0.000<0.01,χ~2=30.587).The HAMD scores of patients in the control group were lower than before treatment after 2,4,and 6 weeks,and the difference was statistically significant(P<0.05).The HAMD scores of patients in the treatment group were lower than before treatment after 1,2,4,and 6 weeks of treatment.There was statistical significance(P<0.05),and the HAMD score of the treatment group was better than that of the control group after 4 and 6 weeks of treatment.The difference between the two groups was statistically significant(P<0.05).The adverse reaction rate of the two groups of patients was nausea and vomiting,1 case of abdominal distension,1 case of dry mouth,bitter mouth,and dizziness in the treatment group;nausea and vomiting,4 cases of abdominal distension,and 1 case of increased heart rate in the control group,dry mouth,bitter mouth,and head.One case was faint.After symptomatic treatment,some of the symptoms of the two groups were gradually relieved,and gradually disappeared with the extension of the treatment period.The adverse reaction rate of the treatment group was lower than that of the control group.All patients completed the treatment plan as required,and there were no cases of shedding.Conclusion The Cranial suture needle thorn method is better for the treatment of depression,also can effectively reduce depression in patients with Hamilton Depression Scale(HAMD)score and faster onset time,reduce adverse drug reactions,so it is worthy of clinical spreading.