耳穴压豆、针刺治疗肝郁化火型抑郁障碍合并失眠的疗效比较

Comparison of efficacy of auricular points plaster therapy and acupuncture in treating fire derived from stagnation of liver-Qi type of depression disorder combined with insomnia

目的对比研究耳穴压豆、针刺治疗肝郁化火型抑郁障碍合并失眠的临床疗效。方法90例肝郁化火型抑郁障碍合并失眠患者,根据治疗方法不同分为药物对照组、耳穴压豆组、针刺组,各30例。药物对照组给予常规西药治疗,耳穴压豆组给予耳穴压豆治疗,针刺组给予针刺治疗。比较三组治疗前后的匹兹堡睡眠质量指数量表(PSQI)评分、汉密尔顿抑郁量表(HAMD)评分、副反应发生情况。结果治疗后1、2、4周,耳穴压豆组PSQI评分分别为(12.11±1.37)、(9.85±1.33)、(5.34±0.98)分,针刺组PSQI评分分别为(12.16±1.71)、(9.76±1.41)、(5.32±1.03)分,均低于药物对照组的(13.01±1.25)、(11.42±1.56)、(9.17±1.21)分,差异有统计学意义(P<0.05)。治疗后1、2、4周,耳穴压豆组与针刺组PSQI评分比较,差异无统计学意义(P>0.05)。治疗后1、2、4周,耳穴压豆组HAMD评分分别为(15.55±1.36)、(9.75±1.34)、(3.65±1.22)分,针刺组HAMD评分分别为(15.53±1.21)、(10.17±1.20)、(3.78±1.17)分,均低于药物对照组的(19.76±3.34)、(13.56±1.79)、(6.43±1.87)分,差异有统计学意义(P<0.05)。治疗后1、2、4周,针刺组与耳穴压豆组HAMD评分比较,差异无统计学意义(P>0.05)。治疗后1、2、4周,耳穴压豆组、针刺组副反应发生率低于药物对照组,差异有统计学意义(P<0.05)。治疗后1、2、4周,耳穴压豆组与针刺组副反应发生率比较,差异无统计学意义(P>0.05)。结论耳穴压豆、针刺治疗肝郁化火型抑郁障碍合并失眠疗效相当,患者耐受性均较好,值得推广。

Objective To compare the clinical efficacy of auricular points plaster therapy and acupuncture in treating fire derived from stagnation of liver-Qi type of depression disorder combined with insomnia.Methods A total of 90 patients with fire derived from stagnation of liver-Qi type of depression disorder and insomnia were divided into drug control group,auricular points plaster therapy group,and acupuncture group according to different treatment methods,with 30 cases in each group.The drug control group was treated with conventional western medicine,the auricular points plaster therapy group was treated with auricular points plaster therapy,and the acupuncture group was treated with acupuncture.The Pittsburgh Sleep Quality Index Scale(PSQI)score and Hamilton Depression Scale(HAMD)score before and after treatment,and the occurrence of side reaction were compared among the three groups.Results At 1,2 and 4 weeks after treatment,the PSQI scores of auricular points plaster therapy group were(12.11±1.37),(9.85±1.33),(5.34±0.98)points,and those of acupuncture group were(12.16±1.71),(9.76±1.41),(5.32±1.03)points,which were lower than those of(13.01±1.25),(11.42±1.56)and(9.17±1.21)points of the drug control group,and the differences werestatistically significant(P<0.05).At 1,2 and 4 weeks after treatment,there was no statistically significant difference in PSQI score between auricular points plaster therapy group and acupuncture group(P>0.05).At 1,2 and 4 weeks after treatment,HAMD scores of auricular points plaster therapy group were(15.55±1.36),(9.75±1.34),(3.65±1.22)points,and those of acupuncture group were(15.53±1.21),(10.17±1.20),(3.78±1.17)points,which were lower than those of(19.76±3.34),(13.56±1.79)and(6.43±1.87)points in the control group,and the differences were statistically significant(P<0.05).At 1,2 and 4 weeks after treatment,there was no statistically significant difference in HAMD score between acupuncture group and auricular points plaster therapy group(P>0.05).At 1,2 and 4 weeks after treatment,the incidences of side reaction in auricular points plaster therapy group and acupuncture group were lower than those in drug control group,and the differences were statistically significant(P<0.05).At 1,2 and 4 weeks after treatment,there was no statistically significant difference in the incidence of side reaction between the auricular points plaster therapy group and acupuncture group(P>0.05).Conclusion The efficacy of auricular points plaster therapy and acupuncture in the treatment of fire derived from stagnation of liver-Qi type combined with insomnia is comparable,patients have good tolerance,which is worthy of promotion.