抑郁症采用针刺结合心理治疗之临床疗效观察

发布时间：2018-05-07 17:29

本文选题：抑郁症 + 针刺治疗　；参考：《广州中医药大学》2013年博士论文

【摘要】：抑郁症的产生因素,具有“多因素”特性,含生物、心理、社会、环境等因素。病理的改变特色,具有“多环节”特质,有心理造成生理,也有生理造成心理障碍。抑郁症的治疗方法也因此形成“多标靶”特性,西医由脑生化入手,中医由气血、阴阳着手,心理从情绪、压力纾解出发,来研究病患；症型属于“中、重度抑郁症”,采取“针刺加心理治疗”,是一个有效的治疗方法。目的：观察及对照心理治疗、心理加上针刺处方对抑郁症的治疗效果,比较两者的疗效特点和差异,并探讨针刺与心理治疗抑郁症的作用机理。方法：将66例符合纳入标准的患者随机分为两组,对照组33例,采用心理治疗；治疗组33例,采用针刺加上心理治疗。治疗组取穴：百会、四神聪、印堂、内关、神门、太冲、三阴交。随症配穴：神志不安,加本神、神庭；肝火上亢,加行间、侠溪；痰热内扰,加丰隆、内庭；心脾两虚,加心俞、脾俞；肝肾阴虚,加太溪；心肾不交,加心俞、肾俞；心胆气虚,加心俞、胆俞。心理治疗方法,采取精神分析法、人本中心法、认知治疗法、压力调适法、EQ管理法、人际关系法等。治疗前后采用汉米尔(HAMD)量表,抑郁自评量表(SES)、整体效果评估表(CES),进行评分疗效的比较。成果：两组治疗后,各评量表均有降低,其差异具有统计学意义(P0.05),两组在、HAMD及SDS量表评分前后比较,有显着差(P0.01),针心组明显有效率达96.96%,心理治疗组明显有效达51.15%,两组治疗效果有极显着差异(P0.01)。结论：针刺加心理治疗与心理治疗处方,对抑郁症均具有治疗效果,针心组在“临床疗效”与“治疗效率”均明显优于心理组。针心组在“心神不定”、“身心焦虑”、“人际压力”、“情绪低落”、“食欲减低”、“睡眠”、“疲倦乏力”、“失去兴趣”等九项均优于心理组。针刺、心理治疗都有助于患者减低药物的依赖性。采取“身心兼治”是一个有效的途径。
[Abstract]:The causes of depression include biological, psychological, social and environmental factors. The characteristic of pathological changes is multi-link, psychological cause physiology, and physiology cause psychological obstacle. The treatment of depression is therefore characterized by "multiple targets". Western medicine starts with brain biochemistry, TCM begins with qi and blood, yin and yang, and psychology studies patients from emotional and stress relief; the symptomatic type belongs to "moderate and severe depression." It is an effective method to take acupuncture plus psychotherapy. Objective: The therapeutic effects of psychological and acupuncture prescriptions on depression were observed and compared. The characteristics and differences of therapeutic effects were compared and the mechanism of acupuncture and psychotherapy for depression was discussed. Methods: 66 patients who met the inclusion criteria were randomly divided into two groups: the control group (n = 33) and the treatment group (n = 33). Treatment group: Baihui, Sishen Cong, Yin Tang, Neiguan, Shenmen, Taichung, Sanyinjiao. Syndromes with acupoints: uneasiness of mind, plus God, Shenting; liver-fire hyperactivity, plus interline, Xiaxi; phlegm heat internal disturbance, Jiafeng long, inner atrium; deficiency of heart and spleen, plus heart and spleen, spleen Yu; liver and kidney yin deficiency, plus Taixi; Heart and kidney do not cross, plus heart Yu, kidney Yu; Heart gallbladder qi deficiency, plus heart Yu, gallbladder Yu. Psychotherapy, psychoanalysis, human-centered approach, cognitive therapy, stress adjustment, EQ management, interpersonal relationship, etc. Before and after treatment, Hamil's Hamd scale, self rating Depression scale (SESX), and whole effect Assessment form (CESX) were used to evaluate the efficacy. Outcome: After treatment, each rating scale was decreased, and the difference was statistically significant (P 0.05). The scores of Hamd and SDS were compared between the two groups before and after treatment. The effective rate of acupuncture group was 96.96 and that of psychotherapy group was 51.15. There was a very significant difference between the two groups. Conclusion: Acupuncture plus psychotherapy and psychotherapy prescriptions had therapeutic effects on depression, and the acupuncture group was superior to the psychological group in "clinical efficacy" and "therapeutic efficiency". The acupuncture group was superior to the psychological group in nine items such as "restlessness", "physical and mental anxiety", "interpersonal stress", "depression", "loss of appetite", "sleep", "fatigue" and "loss of interest". Acupuncture and psychotherapy can help patients reduce drug dependence. It is an effective way to take both body and mind treatment.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2013
【分类号】：R246.6

【引证文献】