首次针刺对抑郁症躯体症状改善效应观察

发布时间：2018-03-31 22:21

本文选题：针灸　切入点：督脉　出处：《南京中医药大学》2016年硕士论文

【摘要】：目的通过针刺抑郁症患者督脉压痛点,观察比较针刺加药物组与单纯药物组之间的躯体症状改善情况,判断该针刺方法在首次针刺后对躯体化症状是否存在改善效应,以及改善了哪些躯体症状或症状群。方法根据中国精神障碍分类与诊断标准第3版(CCMD-3)纳入2014年11月一2015年8月南京市脑科医院203病区和南京中医药大学国医堂的抑郁症患者61例。在患者纳入后,签署相关知情同意,填写躯体症状相关量表。医者手持毫针刺入压痛点,反复地提插捻转从而使患者产生柔和的、舒适的、持久的针感,每10分钟行针一次,留针30-40分钟。并且根据诊察所得的压痛点的形状,采用灵活的刺法,角度和深度随穴位的形状改变。观察首次针灸治疗过程中即刻效应以及第二次治疗前的效应,统计数据,了解躯体化症状改善情况。结果1.针刺加药物组与单纯药物组相比,在“头颈部、胸背部、胃肠道和腰部”症状改善存在统计学差异。2.针刺加药物组与单纯药物组,在“颈部疼痛”症状方面存在统计学差异；在“背痛”症状方面存在统计学差异；在“腰痛”症状改善方面存在统计学差异。3.在首次治疗前后,针刺加药物组与单纯药物组之间各量表得分无统计学差异。4.在首次治疗前后,针刺加药物组汉密尔顿(HAMD-17)量表前后得分存在统计学差异；抑郁和躯体症状(DSSS-22)量表得分存在统计学差异；躯体健康(PHQ-15)量表得分存在统计学差异。5.单纯药物组在首次给药后,汉密尔顿量表得分存在统计学差异；抑郁躯体量表与躯体健康问卷表无统计学差异。6.单纯药物组首次治疗后汉密尔顿量表睡眠因子前后存在统计学差异；其它因子分无统计学差异。7.两组在首次干预后,PHQ-15因子分得分无统计学差异。针刺加药物组疼痛、胃肠道症状得分在治疗前后存在统计学差异；单纯药物组各因子分在单纯药物给药后并无统计学差异。结论1.针刺督脉压痛点对抑郁症患者安全有效,可以改善躯体化症状；2.针刺督脉压痛点对抑郁症患者疼痛、胃肠道躯体化症状有效；
[Abstract]:Objective to observe and compare the improvement of somatic symptoms between the acupuncture plus medicine group and the simple drug group, and to judge whether the acupuncture method can improve the somatization symptoms after the first acupuncture. Methods according to the third edition of Chinese criteria for classification and diagnosis of mental disorders, CCMD-3 was included in the department 203 of Nanjing brain Hospital and the National Medical Hall of Nanjing University of traditional Chinese Medicine from November to August 2015. 61 patients with depression. Sign the relevant informed consent, fill in the somatosensory scale. The doctor holds the needle into the tenderness point and repeatedly twists and twists it so that the patient has a soft, comfortable, lasting needling sensation, which is given every 10 minutes. The needle was kept for 30-40 minutes. According to the shape of the tenderness point, the angle and depth changed with the shape of the acupoint. The immediate effect during the first acupuncture treatment and the effect before the second treatment were observed. To understand the improvement of somatization symptoms 1.Compared with the simple drug group, the improvement of the symptoms of the acupuncture plus medicine group was statistically different in the "head and neck, chest and back, gastrointestinal tract and waist". There were statistical differences in "neck pain" symptoms, "back pain" symptoms, and "low back pain" symptoms improvement. 3. Before and after the first treatment, There was no statistical difference between the acupuncture plus medicine group and the simple drug group. 4. Before and after the first treatment, there was statistical difference between the acupuncture plus medicine group before and after the Hamilton Hamd 17) scale score. The scores of depression and somatic symptoms were statistically different from those of DSSS-22, and the scores of PHQ-15) were significantly different. There was no statistical difference between somatic depression scale and somatic health questionnaire. There was no significant difference in other factor scores between the two groups after the first intervention. There was no statistical difference in the scores of PHQ-15 between the two groups. There were significant differences in the scores of pain and gastrointestinal symptoms before and after treatment in the acupuncture plus drug group. There was no statistical difference in the factor scores of the simple drug group after drug administration. Conclusion 1.Acupuncture of du pulse tenderness point is safe and effective for patients with depression and can improve somatization symptoms 2.Acupuncture of du pulse tenderness point can be used to treat the pain of depression patients. 2. Somatization of gastrointestinal tract is effective;
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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