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电针和选择性 5-羟色胺再摄取抑制剂治疗重性抑郁症的因子分析:一项 8 周对照临床试验。

Factor analysis of electroacupuncture and selective serotonin reuptake inhibitors for major depressive disorder: an 8-week controlled clinical trial.

机构信息

School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.

Chinese Medicine Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China.

出版信息

Acupunct Med. 2020 Feb;38(1):45-52. doi: 10.1136/acupmed-2017-011412. Epub 2019 Sep 23.

Abstract

BACKGROUND

There is evidence supporting electroacupuncture (EA) for the treatment of major depressive disorder (MDD), but its characteristics have not been well investigated.

OBJECTIVE

To investigate the effectiveness and characteristics of EA in MDD.

METHODS

60 subjects were enrolled-35 in the EA group and 25 in the selective serotonin reuptake inhibitor (SSRI) group based on their preferences-in an 8-week non-randomised controlled clinical trial. The 24-item Hamilton depression rating scale (HAMD-24) and clinical global impression (CGI) were adopted for clinical assessment. The Columbia suicide severity rating scale and adverse event form were used to measure safety and tolerability. The characteristics of EA and SSRIs were compared by analysing seven factors of the HAMD-24.

RESULTS

There was no significant difference between the two groups in terms of HAMD-24 response rate after intervention (P>0.05). Patients treated with EA demonstrated a significant reduction in CGI scores (P<0.05) with fewer adverse events compared with SSRIs (P<0.01). Although HAMD-24 factor analysis showed both EA and SSRIs could improve factor scores in cognitive impairment, diurnal variation, retardation, sleep disturbance, anxiety/somatisation and feelings of despair, EA showed greater improvement in anxiety/somatisation and feelings of despair than SSRIs (P<0.05).

CONCLUSIONS

There was no significant difference between EA and SSRIs in the treatment of MDD with respect to our primary outcome. However, as a potential therapy for MDD, EA appeared to result in greater symptom improvement than SSRI treatment with respect to anxiety/somatisation and feelings of despair. The results of this secondary analysis should be interpreted cautiously given the inherent issues of multiple testing.

摘要

背景

有证据支持电针(EA)治疗重度抑郁症(MDD),但尚未很好地研究其特点。

目的

探讨 EA 在 MDD 中的疗效和特点。

方法

根据患者的偏好,将 60 名受试者纳入 8 周非随机对照临床试验,其中 35 名受试者纳入 EA 组,25 名受试者纳入选择性 5-羟色胺再摄取抑制剂(SSRI)组。采用汉密尔顿抑郁评定量表(HAMD-24)和临床总体印象量表(CGI)进行临床评估。采用哥伦比亚自杀严重程度评定量表和不良事件表来衡量安全性和耐受性。通过分析 HAMD-24 的七个因子比较 EA 和 SSRI 的特点。

结果

干预后两组 HAMD-24 应答率无显著差异(P>0.05)。与 SSRI 相比,EA 组患者 CGI 评分显著降低(P<0.05),且不良反应较少(P<0.01)。尽管 HAMD-24 因子分析显示 EA 和 SSRI 均可改善认知障碍、昼夜变化、迟滞、睡眠障碍、焦虑/躯体化和绝望感等因子评分,但 EA 在焦虑/躯体化和绝望感方面的改善程度优于 SSRI(P<0.05)。

结论

就我们的主要结局而言,EA 与 SSRI 在治疗 MDD 方面没有显著差异。然而,作为 MDD 的潜在治疗方法,与 SSRI 治疗相比,EA 似乎在焦虑/躯体化和绝望感方面能带来更大的症状改善。鉴于多次检验的固有问题,应谨慎解释这一二次分析的结果。

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