蒙医温针治疗抑郁伴失眠的临床随机对照研究

A clinical randomized controlled study of Mongolian medicine warm acupuncture in the treatment of depression with insomnia

背景:抑郁症常伴有失眠,长期的失眠又会引发抑郁情绪恶化,形成恶性循环,严重影响工作生活及身心健康,目前缺少蒙医温针对抑郁失眠疗效的研究。目的:通过临床随机安慰对照研究,评价蒙医温针治疗抑郁症失眠的有效性及安全性。方法:纳入我院针灸科及心理睡眠科志愿者,随机分为蒙医温针组、普通针灸组、米安色林组,每组30例,以PHQ-9以及PSQI量表为主要疗效评价指标,SF-36量表为次要疗效评价指标,分别在治疗前、治疗结束时、疗程结束后1个月进行评测,并随时记录研究过程中的不良反应进行安全性评估。结果:蒙医温针组与米安色林组比较,治疗结束、随访1个月时PHQ-9(P=0.000)、PSQI评分(P=0.000),差异有统计学意义;普通针灸组与米安色林组比较,PHQ-9(P=0.026)、PSQI评分(P=0.001),差异有统计学意义;蒙医温针组治疗后各时点SF-36生活质量8个维度评分均较治疗前上升(P<0.05);疗程结束时,蒙医温针组有效率为46.67%(14/30),普通针灸组为36.67%(11/30),米安色林组为20.00%(6/30),三组有效率两两比较差异有统计学意义(P<0.05)。结论:蒙医温针与普通针灸两种干预方案能降低PHQ-9以及PSQI量表评分,提高SF-36生活质量量表8个维度评分,有效改善抑郁、失眠症状及生活质量,蒙医温针在改善睡眠方面较普通针灸更有优势。

Background:Depression is often accompanied by insomnia,and long-term insomnia will lead to the deterioration of depression,forming a vicious circle,which seriously affects work life and physical and mental health.Currently,there is a lack of research on the efficacy of Mongolian medicine on depression and insomnia.Objective:To evaluate the efficacy and safety of Mongolian medicine warm acupuncture in the treatment of depression and insomnia through a clinical randomized placebo-controlled study.Methods:Volunteers from the Department of Acupuncture and Moxibustion and the Department of Psychology and Sleep in our hospital were enrolled and randomly divided into Mongolian medicine warm needling group,ordinary acupuncture group and Mianserin group,30 cases in each group.PHQ-9 and PSQI scales were used as the main curative effect evaluation index,SF-36 scale is the secondary efficacy evaluation index,before treatment,at the end of treatment,and at the end of the course of treatment.The evaluation was conducted one month later,and adverse reactions and side effects during the study were recorded at any time for safety assessment.Results:Compared with the Mianserin group,the Mongolian medicine warm acupuncture group had statistically significant differences in PHQ-9(P=0.000)and PSQI score(P=0.000)at the end of treatment and at the 1-month follow-up.Compared with the Serin group,the PHQ-9(P=0.026)and PSQI scores(P=0.001)had significant differences;the Mongolian medicine warm needling group had 8dimensions of SF-36 quality of life scores at each time point after treatment.At the end of the course of treatment,the effective rate of Mongolian medicine warm acupuncture group was 46.67%(14/30),that of common acupuncture group was36.67%(11/30),and that of mianserin group was 20.00%(6/30)(P<0.05).Conclusion:Mongolian medicine warming acupuncture and ordinary acupuncture can reduce the scores of PHQ-9 and PSQI scale,improve the scores of 8 dimensions of SF-36 quality of life scale,and effectively improve symptoms of depression,insomnia and quality of life.Acupuncture has advantages over ordinary acupuncture in improving sleep.