曹永康 罗梅桂 孔玉芳

摘要 目的：观察经络氧电针合药线灸治疗抑郁伴失眠的临床疗效和安全性。方法：将80例以失眠为主诉的抑郁症患者随机分为观察组和对照组，每组40例，观察组予经络氧电针合药线灸治疗，对照组予盐酸氟西汀胶囊治疗，疗程4周。采用汉密顿抑郁量表（HAMD-24）、匹兹堡睡眠质量指数量表（PSQI）和不良反应量表（TESS）分别于治疗后1、2、3、4周末评估临床疗效和安全性。结果：2组HAMD和PSQI评分治疗2周后均显著下降（P<0.05）;4周末观察组HAMD和PSQI评分显著低于对照组（P<0.05）;观察组TESS分值显著低于对照组（P<0.05）。结论：经络氧电针合药线灸治疗抑郁伴失眠的疗效优于盐酸氟西汀胶囊组，不良反应较少。

关键词 抑郁症;失眠;经络氧电针;药线灸

Abstract Objective：To observe the clinical efficacy and safety of meridian oxygen electroacupuncture combined with medicated thread moxibustion in the treatment of depression patients with insomnia as the main complaint.Methods：Eighty depression patients with insomnia as the main complaint were randomly divided into an experimental group and a control group，40 for each.For 4 weeks，the experimental group was treated with meridian oxygen electroacupuncture combined with medicated thread moxibustion，while the control group was treated with fluoxetine hydrochloride capsules.Clinical efficacy and safety were measured by Hamilton Rating Scale for Depression（HAMD-24），revised Pittsburgh Sleep Quality Index（PSQI）and Treatment Emergent Symptom Scale（TESS）respectively.And the results of the two groups were compared at the end of each week.Results：After 2 weeks of treatment，the HAMD and PSQI scores of both groups decreased significantly（P<0.05）.After 4 weeks of treatment，the HAMD and PSQI score of the experimental group was significantly lower than that of the control group（P<0.05）.The TESS score of the experimental group was significantly lower than that of the control group（P<0.05）.Conclusion：Meridian oxygen electroacupuncture combined with medicated thread moxibustion is more effective in treating depression patients with insomnia as main complaint than fluoxetine hydrochloride capsules，and its adverse effects are few.

Keywords Depression;Insomnia;Meridian oxygen electroacupuncture therapy;Medicated thread moxibustion

中图分类号：R246.6 文献标识码：A doi：10.3969/j.issn.2095-7130.2020.05.020

抑郁症是临床最常见的精神疾病之一，大约20%的人一生中受到抑郁症的影响，目前约有3亿多人罹患抑郁症。失眠是抑郁症主要症状和共病症状，有效治疗失眠能够更好治疗抑郁症[1-2]。西药治疗疗效肯定，但不良反应较多、依从性较差。本文主要研究经络氧电针合药线灸治疗以失眠为主诉的抑郁症的临床疗效和安全性，现报道如下。

1 资料与方法

1.1 一般资料 选取2017年1月1日至2019年6月30日广西南宁市第五人民医院的門诊和住院患者80例作为研究对象，随机分为观察组和对照组，每组40例。观察组完成35例，平均年龄（34.17±11.78）岁，平均病程（14.77±10.12）个月，平均体质量（55.03±6.58）kg。对照组完成36例，平均年龄（36.42±12.67）岁，平均病程（15.25±8.42）个月，平均体质量（57.36±8.10）kg。2组一般资料比较，差异无统计学意义（P>0.05），具有可比性。本研究经广西南宁市第五人民医院医学伦理委员会批准，均征得患者同意并签署知情同意书。

1.2 纳入标准 1）符合《ICD-10精神与行为障碍分类》中抑郁症的诊断标准;2）HAMD-24>20分;3）PSQI总分≥8分;4）年龄18～60岁。