Cai Hui-Qian, Su Sheng-Yong, Zhang Xi, Dai Qi, Huang Mei, Lin An
First Clinical Medical College of Guangxi University of CM, Nanning 530023, China.
Department of Acupuncture and Moxibustion, First Affiliated Hospital of Guangxi University of CM, Nanning 530023.
Zhongguo Zhen Jiu. 2021 Sep 12;41(9):1005-9. doi: 10.13703/j.0255-2930.20200721-k0002.
To observe the effect of auricular acupuncture on reduction rate of sertraline hydrochloride, and to explore the long-term efficacy of auricular acupuncture in patients with depression.
Seventy-two patients with depression were randomly divided into an observation group (36 cases, 1 case dropped off) and a control group (36 cases, 2 cases dropped off). The patients in the control group were treated with conventional dosage reduction method, that is, the dosage of sertraline hydrochloride was reduced by 25% every week until the dosage was stopped completely on the premise of no aggravation of depressive symptoms. Based on the conventional dosage reduction method used in the control group, the patients in the observation group were treated with auricular acupuncture at Xin (CO), Gan (CO), Shenmen (TF), Pizhixia (AT) and Neifenmi (CO), once every 3 days for 4 weeks. The reduction of dosage was observed before dosage reduction, after 1, 2, 3, 4 weeks of dosage reduction and follow-up 6 months after the end of treatment; the rate of dosage reduction was observed after 4 weeks of dosage reduction and during follow-up; the Hamilton depression scale (HAMD) was used to evaluate the depression severity before dosage reduction, after 4 weeks of dosage reduction and during follow-up; the incidence rate of withdrawal syndrome and clinical efficacy were compared between the two groups.
The dosage of sertraline hydrochloride in the observation group was less than that in the control group after 2, 3, 4 weeks of dosage reduction and during follow-up (<0.05). The dosage reduction rates were 80.6% and 82.2% after 4 weeks of dosage reduction and during follow-up in the observation group, which were higher than 65.8% and 62.2% in the control group (<0.05). After 4 weeks of dosage reduction, the HAMD scores in the two groups were higher than those before dosage reduction (<0.05), and the HAMD score in the observation group was lower than that in the control group (<0.05). During follow-up, HAMD score in the observation group was lower than that in the control group and that after 4 weeks of dosage reduction (<0.05), while HAMD score in the control group was higher than that before dosage reduction and that after 4 weeks of treatment (<0.05). The incidence rate of withdrawal syndrome in the observation group was 11.4% (4/35), which was lower than 47.1% (16/34) in the control group (<0.05). After 4 weeks of dosage reduction and during follow-up, the total effective rate was 97.1% (34/35) in the observation group, which was higher than 79.4% (27/34) in the control group (<0.05).
Auricular acupuncture could effectively reduce the dosage of sertraline hydrochloride, improve the dosage reduction rate, reduce the incidence of withdrawal syndrome and reduce the risk of long-term recurrence in patients with depression.
观察耳针疗法对盐酸舍曲林减药速率的影响，探讨耳针疗法对抑郁症患者的远期疗效。
将72例抑郁症患者随机分为观察组（36例，脱落1例）和对照组（36例，脱落2例）。对照组采用常规减药方法，即在抑郁症状无加重的前提下，每周将盐酸舍曲林剂量减少25%，直至完全停药。观察组在对照组常规减药方法基础上，于耳穴心（CO）、肝（CO）、神门（TF）、皮质下（AT）、内分泌（CO）进行耳针治疗，每3天1次，共4周。观察减药前、减药1、2、3、4周及治疗结束后随访6个月时的减药情况；观察减药4周及随访期间的减药速率；采用汉密尔顿抑郁量表（HAMD）评估减药前、减药4周及随访期间的抑郁严重程度；比较两组撤药综合征发生率及临床疗效。
减药2、3、4周及随访期间，观察组盐酸舍曲林剂量低于对照组（<0.05）。观察组减药4周及随访期间的减药速率分别为80.6%和82.2%，高于对照组的65.8%和62.2%（<0.05）。减药4周后，两组HAMD评分均高于减药前（<0.05），且观察组HAMD评分低于对照组（<0.05）。随访期间，观察组HAMD评分低于对照组及减药4周后（<0.05），而对照组HAMD评分高于减药前及治疗4周后（<0.05）。观察组撤药综合征发生率为11.4%（4/35），低于对照组的47.1%（16/34）（<0.05）。减药4周及随访期间，观察组总有效率为97.1%（34/35），高于对照组的79.4%（27/34）（<0.05）。
耳针疗法可有效降低抑郁症患者盐酸舍曲林剂量，提高减药速率，降低撤药综合征发生率，降低远期复发风险。
