School of Nursing, the Hong Kong Polytechnic University, Hong Kong SAR.
Psychogeriatrics team, Kwai Chung Hospital, Hong Kong SAR.
Aging Ment Health. 2020 Jun;24(6):1001-1009. doi: 10.1080/13607863.2019.1584789. Epub 2019 Mar 14.
The primary aim of the current trial was to assess the clinical effectiveness of acupressure in the management of depression in elderly people compared to patients receiving sham acupressure or standard care alone. Randomized sham-controlled trial of acupressure, sham acupressure and standard care alone in older patients with depression living in the community. Patients with a score>/=8 in the Geriatric Depression Scale were recruited for this study. Intervention/sham treatments were provided four times/week for three months. Assessments related to depressive symptoms (primary outcome), well-being, resilience, spirituality and quality of life domains were carried out at baseline, end of the intervention and three-months after the intervention. 118 patients were randomized to intervention (n = 40), sham (n = 40) or control arm (n = 38), with 84 patients providing final analysis data. Significant reduction in mean score of depressive symptoms was found in the acupressure group (from 10.6 (sd = 0.03) to 7.7 (sd = 0.07), p < 0.001 at end of intervention and 8.7 (sd = 0.8), p = 0.002 at follow-up) and the sham acupressure group (from 10.5 (sd = 0.3) to 8.4 (sd = 0.8), p = 0.005) at end of intervention and 8.4 (sd = 0.8), p = 0.006 at follow-up but not in the control group (from 10.8 to 9.9, p = 0.20). Resilience (p = 0.02) and spirituality (p = 0.02) were also improved in the intervention group at the end of intervention assessment but this change was not sustained at follow-up. Mind-body-spirit well-being and social functioning were improved both at the end of intervention and follow-up in the experimental as well as sham group. The sham group showed additional improvements in daily functioning and environmental quality of life. Although acupressure improved outcomes, a placebo effect was evident. Acupressure may be an effective approach to manage depression in elderly patients, but more evidence is needed in the future before it can be recommended for practice as well as more clear elucidation of any placebo effects.
当前试验的主要目的是评估在管理老年抑郁症方面，穴位按压与假穴位按压或单独标准护理相比的临床效果。 一项针对社区居住的老年抑郁症患者的穴位按压、假穴位按压和单独标准护理的随机假对照试验。 该研究招募了老年抑郁量表评分≥8 的患者。 干预/假治疗每周进行 4 次，持续 3 个月。 在基线、干预结束时和干预结束后 3 个月进行与抑郁症状（主要结局）、幸福感、韧性、灵性和生活质量相关的评估。 118 名患者被随机分配到干预组（n=40）、假组（n=40）或对照组（n=38），84 名患者提供最终分析数据。 穴位按压组的抑郁症状平均评分显著降低（从 10.6（sd=0.03）降至 7.7（sd=0.07），p<0.001，干预结束时；8.7（sd=0.8），p=0.002，随访时）和假穴位按压组（从 10.5（sd=0.3）降至 8.4（sd=0.8），p=0.005，干预结束时；8.4（sd=0.8），p=0.006，随访时），但对照组没有（从 10.8 降至 9.9，p=0.20）。 干预组的韧性（p=0.02）和灵性（p=0.02）也在干预结束时得到改善，但这种改善在随访时没有持续。 在干预结束时和随访时，实验组和假组的身心精神幸福感和社会功能都得到了改善。 假组在日常功能和环境生活质量方面也有额外的改善。 虽然穴位按压改善了结果，但明显存在安慰剂效应。 穴位按压可能是一种有效的方法来管理老年患者的抑郁症，但未来需要更多的证据才能推荐实践，以及更清楚地阐明任何安慰剂效应。
