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电针对医学生应激相关症状的影响:一项随机安慰剂对照研究。

Effects of electroacupuncture on stress-related symptoms in medical students: a randomised placebo-controlled study.

机构信息

Community Health Institute, Fluminense Federal University, , Niteroi, Rio de Janeiro, Brazil.

出版信息

Acupunct Med. 2014 Feb;32(1):4-11. doi: 10.1136/acupmed-2013-010408. Epub 2013 Oct 10.

Abstract

OBJECTIVE

To assess the effects of electroacupuncture (EA) on relieving stress-related symptoms-sleep disorders, anxiety, depression and burnout-in medical students.

METHODS

Eighty-two students were randomised into an EA treatment group (n=30), a sham TENS group (n=18) and an untreated control group (n=34). EA was applied at a continuous frequency of 2 Hz to the limbs, face, ears and scalp for 20 min once a week, over 6-8 weeks. Sham transcutaneous electrical nerve stimulation (TENS) was performed on similar sites for the same number of times in each session and for the same length of time. Outcome measurements included a comparison of the indices obtained by different self-applied questionnaires before and after treatment. The surveys used were the Mini-Sleep Questionnaire (MSQ), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), the Beck Depression and Anxiety Inventories (BDI and BAI) and the Maslach Burnout Inventory-Student Survey (MBI-SS), in addition to the Quality of Life Questionnaire-abbreviated version (WHOQOL-bref).

RESULTS

EA significantly improved scores on the MSQ, PSQI, BDI and the cynicism and academic efficacy (AE) dimensions of the MBI-SS in relation to the control. Sleep quality (MSQ) improved from 36.9 (SD 7.6) to 25.0 (5.7) with EA, 37.6 (6.0) to 32.1 (6.9) with sham TENS, and 36.5 (5.9) to 33.6 (6.7) in the controls (p=0.0000). Compared with the sham TENS group, EA significantly reduced scores on the PSQI. Score improvements in the sham TENS group in relation to control group were significant in the MSQ, BDI and AE. In the EA group, the number of students with better scores after intervention was significantly higher for the MSQ, PSQI, ESS and BAI. This only occurred for the MSQ in the sham TENS group and for the MSQ and ESS in the control group.

CONCLUSIONS

EA significantly reduced stress-related mental symptoms. The improvement obtained by sham TENS compared with the control group confirmed the presence of a placebo effect resulting from the treatment ritual.

摘要

目的

评估电针对缓解医学生应激相关症状(睡眠障碍、焦虑、抑郁和倦怠)的影响。

方法

82 名学生被随机分为电针治疗组(n=30)、假经皮电刺激(TENS)组(n=18)和未治疗对照组(n=34)。电针治疗每周一次,每次 20 分钟,连续频率为 2Hz,刺激四肢、面部、耳朵和头皮。在每个疗程中,在类似的部位进行相同次数和相同时间的假经皮电刺激(TENS)。疗效评估包括治疗前后不同自我评估问卷的比较。使用的调查包括迷你睡眠问卷(MSQ)、匹兹堡睡眠质量指数(PSQI)、Epworth 嗜睡量表(ESS)、贝克抑郁和焦虑量表(BDI 和 BAI)以及马斯拉奇倦怠量表-学生量表(MBI-SS),此外还有生活质量问卷-简明版(WHOQOL-bref)。

结果

与对照组相比,电针治疗显著改善了 MSQ、PSQI、BDI 和 MBI-SS 的玩世不恭和学术效能(AE)维度的评分。睡眠质量(MSQ)从 36.9(SD 7.6)改善至 25.0(5.7)(电针治疗)、37.6(6.0)改善至 32.1(6.9)(假 TENS 治疗)和 36.5(5.9)改善至 33.6(6.7)(对照组)(p=0.0000)。与假 TENS 组相比,电针治疗显著降低了 PSQI 评分。假 TENS 组与对照组相比,MSQ、BDI 和 AE 评分也有显著改善。在电针治疗组中,干预后 MSQ、PSQI、ESS 和 BAI 评分更好的学生人数显著增加。在假 TENS 组中仅在 MSQ 中,在对照组中仅在 MSQ 和 ESS 中发生这种情况。

结论

电针显著减轻了与应激相关的精神症状。与对照组相比,假 TENS 治疗的改善证实了治疗仪式产生的安慰剂效应的存在。

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