Fan Ling, Fu Wen-Bin, Xu Neng-Gui, Liu Jian-Hua, Fan Li, Ou Ai-Hua
Department of Acupuncture and Moxibustion, Guangdong Provincial Hospital of TCM, Guangzhou 510120, China.
Zhongguo Zhen Jiu. 2012 May;32(5):385-9.
To assess the clinical efficacy of acupuncture and moxibustion on depression in view of the outcome indicators of the patient subjective reports.
One hundred and sixty-three cases of depression being in compliance with the inclusive standards were randomized into a soothing-liver and regulating-mind group, an acupoint-shallow-puncturing group and a non-acupoint-shallow-puncturing group. In the soothing-liver and regulating-mind group, the conventional acupuncture was applied to the four-gate points [Hegu (LI 4) and Taichong (LR 3)], Baihui (GV 20) and Yintang (EX-HN 3), the direct moxibustion with moxa cone was applied to the four-flower points [Geshu (BL 17), Danshu (BL 19)]. Finally, the intradermal needling was used at Xinshu (BL 15) and Ganshu (BL 18). In the acupoint-shallow-puncturing group, the acupoints selected were same as those in the soothing-liver and regulating-mind group. But the needle insertion was shallower and the time of moxibustion was shorter. In the non-acupoint-shallow-puncturing group, the spots that were 10 mm lateral to those acupoints in the soothing-liver and regulating-mind group were selected. The operation was same as that in the acupoint-shallow-puncturing group. The treatment was given twice a week in three groups. Totally, 12 weeks of treatment were required. The score of symptom checklist 90 (SCL-90), the self-report symptom inventory was observed before treatment, 1 month and 3 months after treatment separately so as to assess the corresponding short-term, mid-term and long-term efficacies of the program of acupuncture and moxibustion for soothing the liver and regulating the mind.
In each time-point after treatment, for the scores of somatization, obsessive-compulsive symptom, interpersonal sensitivity, depression, anxiety, hostility, paranoid ideation, psychoticism and the other 8 dimensionalities, in comparison between the soothing-liver and regulating-mind group and the non-acupoint-shallow-puncturing group, the differences were significant statistically (all P < 0.05). For the scores of depression, anxiety and hostility, in comparison between the soothing-liver and regulating-mind group and the acupoint-shallow-puncturing group, the differences were significant statistically (all P < 0.05).
Acupuncture and moxibustion can improve the scores of SCL-90 scale for the patients with depression. The outcome indicators of the patient subjective reports can accurately assess the clinical efficacy.
从患者主观报告的结局指标角度评估针灸治疗抑郁症的临床疗效。
将163例符合纳入标准的抑郁症患者随机分为疏肝调神组、穴位浅刺组和非穴位浅刺组。疏肝调神组采用常规针刺四关穴[合谷(LI 4)、太冲(LR 3)]、百会(GV 20)、印堂(EX-HN 3),麦粒灸四花穴[膈俞(BL 17)、胆俞(BL 19)],最后在心俞(BL 15)、肝俞(BL 18)行皮内针针刺。穴位浅刺组选取与疏肝调神组相同的穴位,但进针更浅,艾灸时间更短。非穴位浅刺组选取在疏肝调神组穴位旁开10 mm处的部位,操作同穴位浅刺组。三组均每周治疗2次,共治疗12周。分别在治疗前、治疗后1个月和3个月观察症状自评量表90(SCL-90)评分,以评估疏肝调神针灸方案相应的短期、中期和长期疗效。
治疗后各时间点,疏肝调神组与非穴位浅刺组相比,在躯体化、强迫症状、人际敏感、抑郁、焦虑、敌对、偏执、精神病性及其他8个维度的评分上,差异均有统计学意义(均P<0.05)。疏肝调神组与穴位浅刺组相比,在抑郁、焦虑和敌对评分上,差异有统计学意义(均P<0.05)。
针灸可改善抑郁症患者的SCL-90量表评分。患者主观报告的结局指标能准确评估临床疗效。