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经皮穴位电刺激治疗创伤后应激障碍的评估盲法随机对照研究。

Transcutaneous electrical acupoint stimulation for post-traumatic stress disorder: Assessor-blinded, randomized controlled study.

机构信息

Department of Psychiatry, Tongde Hospital of Zhejiang Province, Hangzhou, China.

Department of Psychiatry, Yiwu Central Hospital, Yiwu, China.

出版信息

Psychiatry Clin Neurosci. 2019 Apr;73(4):179-186. doi: 10.1111/pcn.12810. Epub 2019 Jan 22.

Abstract

AIM

Transcutaneous electrical acupoint stimulation (TEAS) has the potential to alleviate post-traumatic stress disorder (PTSD). The purpose of this study was to determine whether adding TEAS to sertraline or cognitive behavioral therapy (CBT) could improve the anti-PTSD efficacy.

METHODS

In this randomized controlled trial, 240 PTSD patients (60 in each group) were assigned to receive simulated TEAS combined with sertraline (group A) or with CBT (group B), active TEAS combined with CBT (group C), or active TEAS combined with CBT plus sertraline (group D) for 12 weeks. The outcomes were measured using the Clinician-Administered PTSD Scale, PTSD Check List-Civilian Version, and 17-item Hamilton Rating Scale for Depression.

RESULTS

While PTSD symptoms reduced over time in all patients, groups C and D had markedly greater improvement in both PTSD and depressive measures than groups A and B in all post-baseline measurement points, with moderate to very large effect sizes of 0.484-2.244. Groups C and D also had a significantly higher rate than groups A and B on clinical response (85.0% and 95.0% vs 63.3% and 60.0%, P < 0.001) and on remission (15.0% and 25.0% vs 3.3% and 1.7%, P < 0.001). The incidence of adverse events was similar between groups A and D and between groups B and C.

CONCLUSIONS

Additional TEAS augments the anti-PTSD and antidepressant efficacy of antidepressants or CBT, without increasing the incidence of adverse effects. TEAS could serve as an effective intervention for PTSD and comorbid depression. This trial was registered with www.chictr.org (no.: ChiCTR1800017255).

摘要

目的

经皮穴位电刺激(TEAS)有可能缓解创伤后应激障碍(PTSD)。本研究旨在确定在舍曲林或认知行为疗法(CBT)的基础上增加 TEAS 是否能提高抗 PTSD 疗效。

方法

这是一项随机对照试验,将 240 名 PTSD 患者(每组 60 名)分为四组:接受模拟 TEAS 联合舍曲林(A 组)、接受真实 TEAS 联合 CBT(C 组)、接受真实 TEAS 联合 CBT 加舍曲林(D 组),或接受单纯 CBT(B 组),共治疗 12 周。采用临床医生管理 PTSD 量表、创伤后应激障碍检查表-平民版和汉密尔顿抑郁量表 17 项版评估疗效。

结果

所有患者 PTSD 症状均随时间逐渐减轻,但在所有基线后测量点,C 组和 D 组 PTSD 和抑郁评分的改善均显著优于 A 组和 B 组,效应量大小为 0.484-2.244,具有中到高度的统计学意义。C 组和 D 组的临床反应率(85.0%和 95.0%比 63.3%和 60.0%,P<0.001)和缓解率(15.0%和 25.0%比 3.3%和 1.7%,P<0.001)也显著高于 A 组和 B 组。A 组和 D 组、B 组和 C 组之间不良反应发生率相似。

结论

在舍曲林或 CBT 的基础上增加 TEAS 可增强抗 PTSD 和抗抑郁疗效,而不增加不良反应发生率。TEAS 可作为 PTSD 及共病抑郁的有效干预手段。本试验已在 www.chictr.org 注册(注册号:ChiCTR1800017255)。

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