综合治疗、 therapeutic acupuncture 和常规治疗缓解初级保健患者心理困扰的 6 个月效果 - 一项开放、实用随机对照试验的随访。
Six-month effects of integrative treatment, therapeutic acupuncture and conventional treatment in alleviating psychological distress in primary care patients--follow up from an open, pragmatic randomized controlled trial.
机构信息
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
出版信息
BMC Complement Altern Med. 2014 Jun 30;14:210. doi: 10.1186/1472-6882-14-210.
BACKGROUND
To evaluate and compare 6-month effects of 8 weeks of an integrative treatment (IT), therapeutic acupuncture (TA), and conventional treatment (CT) in reducing symptoms of anxiety, depression and in improving health-related quality of life (HRQL) and sense of coherence (SOC) in psychologically distressed primary care patients.
METHODS
Patients who had participated in an open, pragmatic randomized controlled trial were followed up six months after treatment. The study sample consisted of 120 adults (40 per treatment arm) aged 20 to 55 years referred from four different primary health care centres in western Sweden for psychological distress. Assessments were made at baseline after eight weeks and after 24 weeks. Anxiety and depression were evaluated with the Hospital Anxiety and Depression scale (HADS), HRQL with the SF-36 Mental Component Summary scores (MCS) and SOC with the Sense of Coherence-13 questionnaire.
RESULTS
No baseline differences were found between groups on any outcome variable. At 24 weeks, IT and TA had significantly better values than CT on all variables. All three groups showed significant improvements from baseline on all variables, except HAD depression in CT; however, improvements were significantly greater in IT and TA than in CT. IT and TA did not differ on any outcome variable. Effect sizes were large in IT and TA for all variables and small or moderate in CT. Improvements on all variables seen after 8-weeks of IT and TA remained stable at 24 weeks and the CT group improved on HAD anxiety.
CONCLUSIONS
IT and TA seem to be more beneficial than CT in reducing anxiety, depression, and in improving quality of life and sense of coherence after 24 weeks of follow up in patients with psychological distress. More research is needed to confirm these results.
TRIAL REGISTRATION
ISRCTN trial number NCT01631500.
背景
评估并比较 8 周整合治疗（IT）、治疗性针灸（TA）和常规治疗（CT）在减少焦虑、抑郁症状，改善心理健康相关生活质量（HRQL）和心理困扰的初级保健患者的应对感（SOC）方面的 6 个月疗效。
方法
接受过开放、务实的随机对照试验的患者在治疗后 6 个月进行随访。研究样本包括来自瑞典西部四家不同初级保健中心的 120 名年龄在 20 至 55 岁之间的成年人（每组 40 人），因心理困扰而接受治疗。基线评估在 8 周和 24 周后进行。焦虑和抑郁用医院焦虑和抑郁量表（HADS）评估，HRQL 用 SF-36 心理健康成分综合评分（MCS）评估，SOC 用 13 项应对感量表评估。
结果
在任何结局变量上，各组在基线时均无差异。24 周时，IT 和 TA 在所有变量上的得分均显著优于 CT。所有三组在所有变量上均显示出与基线相比的显著改善，除 CT 组的 HADS 抑郁外；然而，IT 和 TA 的改善明显大于 CT。在任何结局变量上，IT 和 TA 之间均无差异。在所有变量上，IT 和 TA 的效应量较大，CT 则为小或中等。在 IT 和 TA 接受 8 周治疗后，所有变量的改善在 24 周时仍保持稳定，CT 组在 HADS 焦虑方面有所改善。
结论
在 24 周的随访中，与 CT 相比，IT 和 TA 似乎更有益于减少焦虑、抑郁，改善生活质量和应对感，在有心理困扰的患者中。需要更多的研究来证实这些结果。
试验注册
ISRCTN 临床试验编号 NCT01631500。
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