大接经针法与常规针刺治疗肝气郁结型轻中度抑郁症的临床疗效比较研究
发布时间：2019-01-06 20:40
【摘要】：目的:比较运用大接经针法与常规针刺治疗肝气郁结型轻中度抑郁症的临床疗效差异,由此验证大接经针法治疗肝气郁结型轻中度抑郁症的可行性及优越性。方法:选取自2014年12月至2016年12月大连医科大学附属第二医院针灸门诊确诊为肝气郁结型轻中度抑郁症患者共计72例,根据治疗方法的不同,随机分为常规针刺组(A)、电针组(B)、大接经组(C)三组进行治疗,每组均为24例,其中常规针刺组(A)入组为24例,脱落1例,共计23例;电针组(B)入组为24例,脱落3例,共计21例;大接经组(C)入组为24例,脱落2例,共计22例。常规针刺组取基本穴位:百会、印堂、四神聪、太阳、风池、内关、足三里、三阴交、阴陵泉、太冲,其中百会、四神聪、印堂、太阳以及风池穴应用平补平泻手法,内关、足三里、三阴交、阴陵泉以及太冲穴应用迎随补泻手法;电针组则在常规针刺组取穴及补泻方法的基础上在百会、印堂穴连接电针;大接经组取穴及补泻方法同常规针刺组,起针后在十二经井穴应用大接经针法,即按照少商到大敦的顺序,依次点刺不留针,每日一次,两侧交替进行。三组患者每日针刺一次,7次为一疗程,连续治疗6个疗程。随访观察三组患者治疗前以及治疗后抑郁量表(HAMD17项版本)评分、抑郁自评量表(SDS)评分、中医证候量化表评分及三种量表评分的变化。所有患者均知情同意并且符合入组标准,能够耐受所有检查以及针灸治疗。将收集的患者数据建立数据库,使用SPSS 22.0统计学软件对数据分析。计数资料采用x2检验;计量资料均数用?X±S表示,三组间均数比较使用单因素方差分析,两两比较则使用独立样本t检验,组内前后比较采用配对样本t检验,均以P0.05认为有统计学意义。结果:1.HAMD总分均值比较:(1)组内比较:三组治疗后HAMD总分均值均比治疗前降低,C组(大接经组)P0.01,有显著性差异,A、B组P0.05,差异有统计学意义。(2)组间比较:A(常规针刺组)、B(电针组)比较P=0.618(P0.05),差异无统计学意义;A组(常规针刺组)、C组(大接经组)P=0.005(P0.01),有显著性差异;B组(电针组)、C组(大接经组)P=0.02(P0.05),差异有统计学意义。2.SDS总分均值比较:(1)组内比较:三组治疗后SDS总分均值均较治疗以前降低,A、B、C组P均小于0.05,差异有统计学意义。(2)组间比较:A(常规针刺组)、B(电针组)P=0.008(P0.01),有显著性差异;A(常规针刺组)、C(大接经组)P=0.001(P0.01),有显著性差异;B组(电针组)、C组(大接经组)P=0.306(P0.05),差异无统计学意义。3.中医证候量化表总分比较:(1)组内比较:三组治疗后中医证候量化表总分均值均较治疗前降低,三组P均小于0.05,差异有统计学意义。(2)组间比较:A(常规针刺组)、B(电针组)P=0.029(P0.05),差异有统计学意义;A(常规针刺组)、C(大接经组)P=0.001(P0.01),有显著性差异;B组(电针组)、C组(大接经组)P=0.046(P0.05),差异有统计学意义。4.总有效率比较:大接经组总有效率是81.82%;电针组总有效率是71.43%;常规针刺组总有效率是65.22%,大接经组总有效率高于电针组和常规针刺组,差异具有统计学意义。结论:1.大接经结合常规针刺治疗肝气郁结型轻中度抑郁症疗效明显优于电针及常规针刺治疗,显著改善了患者心境低落、思维迟缓、睡眠障碍等症状。2.大接经针法通过针刺井穴以激发经气的起始状态,调整全身经络的虚实,调节机体阴阳平衡,从而达到疏肝解郁、醒脑开窍的作用,充分证明了大接经针法在抑郁症临床治疗中的作用。
[Abstract]:Objective: To compare the clinical curative effect of the traditional acupuncture on the treatment of mild and moderate depression of the liver-qi depression, and to verify the feasibility and the superiority of the large-joint needle method in the treatment of the mild-to-moderate depression of the liver-qi. Methods: A total of 72 patients with mild and moderate depression diagnosed by acupuncture and moxibustion in the second hospital from December 2014 to December 2016 were randomly divided into the conventional acupuncture group (A) and the electroacupuncture group (B) according to the different treatment methods. The group (C) was treated in three groups, each group was 24 cases, in which 24 cases were in the conventional acupuncture group (A), 1 case was dropped, 23 cases were dropped, 24 cases were dropped in the electroacupuncture group (B), 3 cases were dropped, 21 cases were in total, 24 cases of the large-joint group (C) and 2 in the fall-off group. A total of 22 cases were reported. The conventional acupuncture group takes the basic acupuncture points: hundreds of meetings, indents, four-god-cong, the sun, the wind pool, the inner-off, the foot-three, the three-yin, the yin-ling spring and the undershoot, wherein the hundreds, the four-god-cong, the print hall, the sun and the wind-pool point are applied with a flat-and-back-up method, an inner-off, a foot-three, a three-yin, The electroacupuncture group is connected with the electro-acupuncture at hundreds of times on the basis of the conventional acupuncture group and the method of tonifying and purging, and the acupuncture group is connected with the conventional acupuncture group through the group taking point and the reinforcing and discharging method, and the acupuncture point method is applied to the twelve through well holes after the needle is used as the needle, That is, according to the order of the young business to the big town, the needle is not left in sequence, once a day, and the two sides are alternately carried out. The three groups of patients were acupuncture once a day, 7 times a course of treatment, and 6 courses of treatment were treated continuously. All three groups were followed up for three groups: pre-treatment and post-treatment depression scale (HAMD17 version) score, depression self-rating scale (SDS) score, syndrome score of TCM syndrome, and change of three scales. All patients had informed consent and met the enrollment criteria to be able to withstand all examinations and acupuncture and moxibustion. The collected patient data was established in the database and the data was analyzed using the SPSS 10.0 statistical software. x2 test is used for counting data, and the number of measurement data is used? X-S indicated that the two comparisons used single-factor analysis of variance, the two comparisons used independent sample t-test, and the pre-and post-group comparisons were tested with the paired samples t, both of which were considered to be of statistical significance. Results: 1. The mean value of the total score of HAMD was as follows: (1) The mean value of the total score of HAMD after three groups of treatment was lower than that of the treatment before treatment. (2) Compared with group A (conventional acupuncture group) and B (electroacupuncture group), P = 0.618 (P0.05), the difference was not significant; group A (conventional acupuncture group), group C (large group) P = 0. 005 (P0.01), there was significant difference; group B (electroacupuncture group), group C (large group of group) P = 0.02 (P0.05), There was a significant difference in the mean value of SDS total score: (1) The mean value of SDS total score was lower in group A, B and C after three groups of treatment, and that of group A, B and C was less than 0.05, and the difference was significant. (2) In group A (conventional acupuncture group), group B (electroacupuncture group) P = 0. 008 (P0.01), there was a significant difference; in group A (conventional acupuncture group), C (large group of acupuncture group), P = 0.001 (P0.01), there was a significant difference; group B (electroacupuncture group), group C (large group by group) P = 0.306 (P0.05), and the difference was not statistically significant. The total score of the total score of the post-treatment of TCM syndrome in the three groups was lower than that of the pre-treatment group (P <0.05), and the difference was of statistical significance. (2) In group A (conventional acupuncture group), B (electroacupuncture group) P = 0.029 (P0.05), the difference was of statistical significance; group A (conventional acupuncture group), C (large group of acupuncture group) P = 0.001 (P0.01), there was significant difference; group B (electroacupuncture group), group C (large group of group) P = 0.046 (P0.05), the difference was statistically significant. The total effective rate of the electroacupuncture group was 81.82%, the total effective rate of the electroacupuncture group was 71.43%, the total effective rate of the conventional acupuncture group was 65. 22%, the total effective rate of the large-joint group was higher than that of the electroacupuncture group and the conventional acupuncture group, and the difference was of statistical significance. Conclusion: 1. the curative effect of the large-joint combined with the conventional acupuncture for treating the depressed mild-to-moderate depression of the liver-qi is obviously superior to that of the electro-acupuncture and the conventional acupuncture treatment, and the symptoms of depression of the mood of the patient, the delay of the thinking, the sleep disorder and the like are obviously improved. The large-joint needle method is used for stimulating the initial state of the gas through the acupuncture well hole, regulating the deficiency and the excess of the whole body and collaterals, regulating the balance of the yin and yang of the body, so as to achieve the effects of soothing the liver and resolving the depression, and restoring the brain and inducing resuscitation, and fully proves the effect of the large-joint acupuncture method in the clinical treatment of the depression.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6
本文编号：2403297
[Abstract]:Objective: To compare the clinical curative effect of the traditional acupuncture on the treatment of mild and moderate depression of the liver-qi depression, and to verify the feasibility and the superiority of the large-joint needle method in the treatment of the mild-to-moderate depression of the liver-qi. Methods: A total of 72 patients with mild and moderate depression diagnosed by acupuncture and moxibustion in the second hospital from December 2014 to December 2016 were randomly divided into the conventional acupuncture group (A) and the electroacupuncture group (B) according to the different treatment methods. The group (C) was treated in three groups, each group was 24 cases, in which 24 cases were in the conventional acupuncture group (A), 1 case was dropped, 23 cases were dropped, 24 cases were dropped in the electroacupuncture group (B), 3 cases were dropped, 21 cases were in total, 24 cases of the large-joint group (C) and 2 in the fall-off group. A total of 22 cases were reported. The conventional acupuncture group takes the basic acupuncture points: hundreds of meetings, indents, four-god-cong, the sun, the wind pool, the inner-off, the foot-three, the three-yin, the yin-ling spring and the undershoot, wherein the hundreds, the four-god-cong, the print hall, the sun and the wind-pool point are applied with a flat-and-back-up method, an inner-off, a foot-three, a three-yin, The electroacupuncture group is connected with the electro-acupuncture at hundreds of times on the basis of the conventional acupuncture group and the method of tonifying and purging, and the acupuncture group is connected with the conventional acupuncture group through the group taking point and the reinforcing and discharging method, and the acupuncture point method is applied to the twelve through well holes after the needle is used as the needle, That is, according to the order of the young business to the big town, the needle is not left in sequence, once a day, and the two sides are alternately carried out. The three groups of patients were acupuncture once a day, 7 times a course of treatment, and 6 courses of treatment were treated continuously. All three groups were followed up for three groups: pre-treatment and post-treatment depression scale (HAMD17 version) score, depression self-rating scale (SDS) score, syndrome score of TCM syndrome, and change of three scales. All patients had informed consent and met the enrollment criteria to be able to withstand all examinations and acupuncture and moxibustion. The collected patient data was established in the database and the data was analyzed using the SPSS 10.0 statistical software. x2 test is used for counting data, and the number of measurement data is used? X-S indicated that the two comparisons used single-factor analysis of variance, the two comparisons used independent sample t-test, and the pre-and post-group comparisons were tested with the paired samples t, both of which were considered to be of statistical significance. Results: 1. The mean value of the total score of HAMD was as follows: (1) The mean value of the total score of HAMD after three groups of treatment was lower than that of the treatment before treatment. (2) Compared with group A (conventional acupuncture group) and B (electroacupuncture group), P = 0.618 (P0.05), the difference was not significant; group A (conventional acupuncture group), group C (large group) P = 0. 005 (P0.01), there was significant difference; group B (electroacupuncture group), group C (large group of group) P = 0.02 (P0.05), There was a significant difference in the mean value of SDS total score: (1) The mean value of SDS total score was lower in group A, B and C after three groups of treatment, and that of group A, B and C was less than 0.05, and the difference was significant. (2) In group A (conventional acupuncture group), group B (electroacupuncture group) P = 0. 008 (P0.01), there was a significant difference; in group A (conventional acupuncture group), C (large group of acupuncture group), P = 0.001 (P0.01), there was a significant difference; group B (electroacupuncture group), group C (large group by group) P = 0.306 (P0.05), and the difference was not statistically significant. The total score of the total score of the post-treatment of TCM syndrome in the three groups was lower than that of the pre-treatment group (P <0.05), and the difference was of statistical significance. (2) In group A (conventional acupuncture group), B (electroacupuncture group) P = 0.029 (P0.05), the difference was of statistical significance; group A (conventional acupuncture group), C (large group of acupuncture group) P = 0.001 (P0.01), there was significant difference; group B (electroacupuncture group), group C (large group of group) P = 0.046 (P0.05), the difference was statistically significant. The total effective rate of the electroacupuncture group was 81.82%, the total effective rate of the electroacupuncture group was 71.43%, the total effective rate of the conventional acupuncture group was 65. 22%, the total effective rate of the large-joint group was higher than that of the electroacupuncture group and the conventional acupuncture group, and the difference was of statistical significance. Conclusion: 1. the curative effect of the large-joint combined with the conventional acupuncture for treating the depressed mild-to-moderate depression of the liver-qi is obviously superior to that of the electro-acupuncture and the conventional acupuncture treatment, and the symptoms of depression of the mood of the patient, the delay of the thinking, the sleep disorder and the like are obviously improved. The large-joint needle method is used for stimulating the initial state of the gas through the acupuncture well hole, regulating the deficiency and the excess of the whole body and collaterals, regulating the balance of the yin and yang of the body, so as to achieve the effects of soothing the liver and resolving the depression, and restoring the brain and inducing resuscitation, and fully proves the effect of the large-joint acupuncture method in the clinical treatment of the depression.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6
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