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随机单盲多中心试验比较标准和增强型针刺方案对抑郁症患者睡眠质量和抑郁症状的影响。

Randomized single-blind multicenter trial comparing the effects of standard and augmented acupuncture protocols on sleep quality and depressive symptoms in patients with depression.

机构信息

a Baoan Hospital, Southern Medical University , Shenzhen , China.

b The Second Clinical Medical College, Guangzhou University of Chinese Medicine , Guangzhou , China.

出版信息

Psychol Health Med. 2018 Apr;23(4):375-390. doi: 10.1080/13548506.2017.1363399. Epub 2017 Sep 12.

Abstract

The study was aimed to compare the effects of standard and augmented acupuncture on depressive symptoms and sleep disturbances in patients with depression. This is a randomized, single-blind, multicenter trial. 140 subjects with clinical insomnia (score of ≥ 7 on the Pittsburgh Sleep Quality Index (PSQI)) were randomized to the standard (LI4, LIV3, EX-HN3, and GV20) or augmented (LI4, LIV3, EX-HN3, GV20, LU7, and KID6, including intradermal needles for sustained treatment) acupuncture groups. Participants received two sessions weekly for six weeks. In trial, The primary outcomes were improvements in PSQI and the Hamilton Rating Scale (HAMD). Secondary outcomes were treatment credibility and adverse events. Outcomes were assessed at baseline, week 3, end of treatment, and 4-week follow-up. From the 105 randomized patients, 89 completed the trial and were included in the final analyses. Better efficacy was observed in the augmented group compared with the standard acupuncture to improve the PSQI and HAMD at week 3, end of treatment, and 4-week follow-up (all p < .05). The HAMD scores improved with time, except between end of treatment and 4-week follow-up, while in the standard group, HAMD scored improved from baseline to week 3, and stopped improving thereafter. The PSQI scores improved with time in the two groups, except between end of treatment and 4-week follow-up. Compared with the standard protocol, the augmented acupuncture protocol had a better efficacy to treat depression and to improve sleep quality of patients with depression.

摘要

本研究旨在比较标准针刺和增强针刺对抑郁症患者抑郁症状和睡眠障碍的影响。这是一项随机、单盲、多中心试验。140 例有临床失眠(匹兹堡睡眠质量指数(PSQI)评分≥7)的患者被随机分为标准(LI4、LIV3、EX-HN3 和 GV20)或增强(LI4、LIV3、EX-HN3、GV20、LU7 和 KID6,包括皮内针持续治疗)针刺组。参与者每周接受两次治疗,共六周。试验中,主要结局是 PSQI 和汉密尔顿抑郁量表(HAMD)的改善。次要结局是治疗可信度和不良事件。结局在基线、第 3 周、治疗结束时和 4 周随访时进行评估。从 105 名随机患者中,有 89 名完成了试验并纳入最终分析。与标准针刺组相比,增强针刺组在第 3 周、治疗结束时和 4 周随访时改善 PSQI 和 HAMD 的效果更好(均 P < 0.05)。HAMD 评分随时间改善,除治疗结束时和 4 周随访时之间外,而在标准组中,HAMD 评分从基线到第 3 周改善,并在此后停止改善。两组的 PSQI 评分均随时间改善,除治疗结束时和 4 周随访时之间外。与标准方案相比,增强针刺方案治疗抑郁症和改善抑郁症患者睡眠质量的疗效更好。

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