不同针灸方法治疗汶川“5.12”地震创伤后应激障碍的临床随机对照研究
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摘要
目的:研究不同针灸方法治疗汶川"5.12"地震创伤后应激障碍(PTSD)的有效性和安全性,筛选针灸治疗的优势方案。方法:采用多中心随机对照的方法,将纳入试验的276例患者随机分配到电针头穴组、电针头穴加灸法组、电针头穴加耳针组、帕罗西汀组,共治疗12周。以PTSD临床监测量表(CAPS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表评分(HAMA)对疗效进行评价。结果:试验完成情况良好,分组均衡,基线可比。CAPS、HAMD和HAMA3个量表积分及减分率组内比较差异均有显著性意义(P<0.01),组间比较电针头穴组与帕罗西汀组减分率的差异有统计学意义(P<0.05),电针头穴加灸法组与帕罗西汀组仅HAMA量表减分率的差异有统计学意义(P<0.05)。结论:电针头穴治疗PTSD的疗效优于帕罗西汀,且安全有效,可作为针灸治疗PTSD的优势方案。
Objective:To study the effectiveness and safety of different acupuncture therapies in treating Posttraumatic stress disorder(PTSD)after Wenchuan‘5.12’earthquake.And choose a desirable acupuncture therapy.Methods:A total of 276 patients were recruited in this trial and randomly divided into four groups:scalp electric acupuncture group(group A),scalp electric acupuncture with moxibustion group(group B),scalp electric acupuncture with auricular acupuncture group(group C)and paroxetine hydrochloride group(group D).Each group was treated for 12 weeks.Patients were scored using Clinicianadministered Scale for DSM-IV(CAPS),Hamilton Depression Rating Scale for Depression(HAMD),and Hamilton Anxiety Scale(HAMA).Results:The study was finished well with a balanced grouping and fine baseline.After the analysis of integrations of CAPS,HAMD,and HAMA,we found that the score differences before and after the treatment were of statistical significance in all four groups(P<0.01).The reductive ratio difference of CAPS,HAMD,and HAMA scores between group A and group D was of statistical significance(P<0.05).And the reductive ratio difference of HAMA score between group B and group D was also of statistical significance(P<0.05).Conclusion:The therapeutic effect of scalp electric acupuncture therapy was better than paroxetine hydrochloride.Furthermore,scalp electric acupuncture therapy was easy to operate,safe,and effective,which may be adopted as a desirable treatment for PTSD.
Objective:To study the effectiveness and safety of different acupuncture therapies in treating Posttraumatic stress disorder(PTSD)after Wenchuan‘5.12’earthquake.And choose a desirable acupuncture therapy.Methods:A total of 276 patients were recruited in this trial and randomly divided into four groups:scalp electric acupuncture group(group A),scalp electric acupuncture with moxibustion group(group B),scalp electric acupuncture with auricular acupuncture group(group C)and paroxetine hydrochloride group(group D).Each group was treated for 12 weeks.Patients were scored using Clinicianadministered Scale for DSM-IV(CAPS),Hamilton Depression Rating Scale for Depression(HAMD),and Hamilton Anxiety Scale(HAMA).Results:The study was finished well with a balanced grouping and fine baseline.After the analysis of integrations of CAPS,HAMD,and HAMA,we found that the score differences before and after the treatment were of statistical significance in all four groups(P<0.01).The reductive ratio difference of CAPS,HAMD,and HAMA scores between group A and group D was of statistical significance(P<0.05).And the reductive ratio difference of HAMA score between group B and group D was also of statistical significance(P<0.05).Conclusion:The therapeutic effect of scalp electric acupuncture therapy was better than paroxetine hydrochloride.Furthermore,scalp electric acupuncture therapy was easy to operate,safe,and effective,which may be adopted as a desirable treatment for PTSD.
引文
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[8]赵竟赛,孟庆丰.丁螺环酮与阿米替林治疗创伤后应激障碍的对照研究.中国民康医学,2008,20(21):2524ZHAO Jing-sai,MENG Qing-feng.Comparative study of Buspirone andAmitriptylineintreatingPosttraumaticstressdisorder.Medical JournalofChinesePeople’sHealth,2008,20(21):2524
[9]尹智,王东明,卢杰.震后灾难心理及其救援对策研究.防灾科技学院学报,2007,9(3):13-16YIN Zhi,WANG Dong-ming,LU Jie.Disaster Mental Health afterEarthquakes and the Countermeasures.Journal of Institute of Disaster-PreventionScienceandTechnology,2007,9(3):13-16
[10]Harris E C,Barraclough B.Suicide as an outcome for mental disorders.Ameta-analysis.BrJPsychiatry,1997,170:205-228
[11]Davidson J R.Recognition and treatment of posttraumatic stress disorderJAMA,2001,286(5):584-588
[12]黄泳,龚伟,邹军,等.头针治疗抑郁发作SCL-90评定结果分析,上海针灸杂志,2004,23(3):5-7HUANG Yong,GONG Wei,ZOU Jun,et al.A Clinical Judgment of SCL-90on Treating50cases of Depression with Scalp Acupuncture.Shanghai Journal of Acupuncture and Moxibustion,2004,23(3):5-7
[13]杜元灏,李桂平.调神疏肝针法治疗郁证的理论基础,中国针灸,2003,19(7):7-9DU Yuan-hao,LI Gui-ping.Theoretical basis of regulating mind and relieving the depressed liver needling method for treatment of depression.ChineseAcupuncture&Moxibustion,2003,19(7):7-9
[14]张虹,赵凌,何成奇,等.头电针治疗血管性痴呆的临床多中心随机对照研究.中国针灸,2008,28(11):783-787ZHANG Hong,ZHAO Ling,HE Cheng-qi,et al.Clinically multi-central randomized controlled study on scalp electroacupuncture for treatment of vascular dementia.Chinese Acupuncture&Moxibu stion,2008,28(11):783-787
[2]Barlow H.David.心理障碍临床手册.3版.刘兴华,黄峥,徐凯文等译.北京:中国轻工业出版社,2004Barlow H.David.Clinical Handbook of Psychologic Obstacle(the thirdedition).TranslatedbyLIUXing-hua,HUANGZheng,XUKai-wen,etal.Beijing:ChinaLightIndustryPress,2004
[3]何新生,灾害创伤后应激障碍的心理干预.城市与减灾,2004,1:20-23HE Xin-sheng.Psychological Intervene of Stress Obstacle after DisasterWounds.CityandDisasterReduction,2004,1:20-23
[4]翟金国,赵靖平.创伤后应激障碍药物治疗新进展及临床评价.中国医院用药评价与分析,2005,5(2):85-88ZHAI Jin-guo,ZHAO Jing-ping.Advancement and Clinical Evaluation of the Drug Therapy for Posttraumatic Stress Disorder.Evaluation and Analysis of Drug-Use in Hospitals of China,2005,5(2):85-88
[5]Tucker P,Zaninelli R,Yehuda R,et a1.Paroxetine in the treatment of chronic post traumatic stress disorder:results of a placebo-controlled,flexibleodosagetrial.JClinPsychiatry,2001,62(11):860
[6]American Phychiatric Association.Diagnostic and statistic manual of mental disorders,4thed(DSM-Ⅳ).Washington DC:APA,1994:424-429
[7]Randall D.Marshall,M.D.,Katherine L.Beebe,et a1.Efficacy and safety of paroxetine treatment for chronic PTSD:a fixed-dose,placebo-controlledstudy.AmJPsychiatry,2001,158:1982-1988
[8]赵竟赛,孟庆丰.丁螺环酮与阿米替林治疗创伤后应激障碍的对照研究.中国民康医学,2008,20(21):2524ZHAO Jing-sai,MENG Qing-feng.Comparative study of Buspirone andAmitriptylineintreatingPosttraumaticstressdisorder.Medical JournalofChinesePeople’sHealth,2008,20(21):2524
[9]尹智,王东明,卢杰.震后灾难心理及其救援对策研究.防灾科技学院学报,2007,9(3):13-16YIN Zhi,WANG Dong-ming,LU Jie.Disaster Mental Health afterEarthquakes and the Countermeasures.Journal of Institute of Disaster-PreventionScienceandTechnology,2007,9(3):13-16
[10]Harris E C,Barraclough B.Suicide as an outcome for mental disorders.Ameta-analysis.BrJPsychiatry,1997,170:205-228
[11]Davidson J R.Recognition and treatment of posttraumatic stress disorderJAMA,2001,286(5):584-588
[12]黄泳,龚伟,邹军,等.头针治疗抑郁发作SCL-90评定结果分析,上海针灸杂志,2004,23(3):5-7HUANG Yong,GONG Wei,ZOU Jun,et al.A Clinical Judgment of SCL-90on Treating50cases of Depression with Scalp Acupuncture.Shanghai Journal of Acupuncture and Moxibustion,2004,23(3):5-7
[13]杜元灏,李桂平.调神疏肝针法治疗郁证的理论基础,中国针灸,2003,19(7):7-9DU Yuan-hao,LI Gui-ping.Theoretical basis of regulating mind and relieving the depressed liver needling method for treatment of depression.ChineseAcupuncture&Moxibustion,2003,19(7):7-9
[14]张虹,赵凌,何成奇,等.头电针治疗血管性痴呆的临床多中心随机对照研究.中国针灸,2008,28(11):783-787ZHANG Hong,ZHAO Ling,HE Cheng-qi,et al.Clinically multi-central randomized controlled study on scalp electroacupuncture for treatment of vascular dementia.Chinese Acupuncture&Moxibu stion,2008,28(11):783-787
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