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电针对减少长期苯二氮䓬类药物使用的作用:一项随机对照试验。

Electroacupuncture for tapering off long-term benzodiazepine use: A randomized controlled trial.

机构信息

School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region.

Department of Psychiatry, The University of Hong Kong, Hong Kong Special Administrative Region.

出版信息

J Psychiatr Res. 2019 Feb;109:59-67. doi: 10.1016/j.jpsychires.2018.11.015. Epub 2018 Nov 22.

Abstract

OBJECTIVE

To evaluate the efficacy of using electroacupuncture as an adjunct treatment in enhancing the benzodiazepine cessation rate in long-term benzodiazepine users.

METHODS

This was a randomized, assessor- and subject-blinded, controlled trial. One hundred and forty-four long-term benzodiazepine users were randomly assigned to receive either electroacupuncture or placebo acupuncture (a sham itervention using non-invasive placebo needles) combined with a gradual benzodiazepine tapering schedule for 4 weeks. The primary outcome was the cessation rate of benzodiazepine use. Subjects were assessed on their benzodiazepine usage, benzodiazepine withdrawal symptoms, insomnia severity, and anxiety and depressive symptoms at baseline, week 6 and week 16.

RESULTS

The cessation rates of the electroacupuncture and placebo acupuncture groups at 12 weeks post-treatment were 9.17% and 10.83%, respectively. Both groups showed a reduction in benzodiazepine usage by a self-completed drug record at week 16 (compared to baseline: electroacupuncture group -40.23% versus placebo acupuncture group -48.76%). However, no significant between-group differences were found in the benzodiazepine cessation rate, reduction in benzodiazepine usage, and other secondary measures across all the study time points.

CONCLUSIONS

Electroacupuncture showed a similar cessation rate in benzodiazepine use to that of non-invasive placebo acupuncture in long-term users during a 4-week gradual tapering schedule. The evidence did not support advantages of electroacupuncture over non-invasive placebo acupuncture on reducing insomnia, anxiety, depression, or other withdrawal symptoms during the gradual tapering schedule. Despite a 40% decrease in the benzodiazepine usage in both groups, the effects may be attributed to the non-specific effects of acupuncture.

TRIAL REGISTRATION

ClinicalTrials.gov # NCT02475538.

摘要

目的

评估电针对长期使用苯二氮䓬类药物患者戒断率的增效作用。

方法

这是一项随机、评估者和受试者双盲、对照试验。144 名长期使用苯二氮䓬类药物的患者被随机分配接受电针或安慰剂针刺(使用非侵入性安慰剂针的假干预),并结合 4 周的苯二氮䓬类药物逐渐减量方案。主要结局是苯二氮䓬类药物使用的戒断率。在基线、第 6 周和第 16 周,评估受试者的苯二氮䓬类药物使用情况、苯二氮䓬类药物戒断症状、失眠严重程度以及焦虑和抑郁症状。

结果

治疗后 12 周时,电针组和安慰剂针刺组的戒断率分别为 9.17%和 10.83%。两组在第 16 周(与基线相比)均通过自我完成的药物记录显示苯二氮䓬类药物使用量减少(电针组减少 40.23%,安慰剂针刺组减少 48.76%)。然而,在所有研究时间点,电针组和安慰剂针刺组在苯二氮䓬类药物戒断率、苯二氮䓬类药物使用量减少以及其他次要措施方面均无显著差异。

结论

在 4 周逐渐减量方案中,与非侵入性安慰剂针刺相比,电针在长期使用苯二氮䓬类药物的患者中显示出相似的戒断率。证据不支持电针对减少逐渐减量方案期间的失眠、焦虑、抑郁或其他戒断症状具有优于非侵入性安慰剂针刺的优势。尽管两组的苯二氮䓬类药物使用量均减少了 40%,但这些效果可能归因于针刺的非特异性作用。

试验注册

ClinicalTrials.gov # NCT02475538。

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