摘要
目的:阐明针灸治疗抑郁发作的有效性、安全性,进而寻求有效的治疗方法,增加患者的依从性,减少复发率。资料来源:应用计算机检索中国期刊全文数据库、万方数据库1999-01/2005-12期间的相关文章,检索词“抑郁症”,或“抑郁发作”或“抑郁性神经症”和“针灸”或“针刺”或“电针”或“穴位注射”或“毫针”或“头针”或“耳针”和“治疗”,限定文章语言种类为中文。资料选择:对资料进行初审,选取有关针刺治疗抑郁发作性心境障碍的基础理论及临床观察的文献,对基础理论的文献进行观点归纳,以及对非随机临床试验的研究进行筛除,对剩余的文献开始查找全文,把属于随机对照临床试验的研究作为纳入标准。资料提炼:概述中引用2篇关于抑郁发作的背景文章,未算入收集文献。共收集到87篇关于针灸治疗抑郁发作的文献,10篇为基础理论,选取论述病因病机的文献6篇,论述治则治法的3篇;其中属于电针疗法的临床研究有17篇,选取了4篇;属于头针疗法的临床研究有10篇,选取了2篇;属于毫针疗法临床研究有24篇,选取了6篇;属于穴位注射疗法的临床研究有2篇,选取了2篇;属于耳针疗法的临床研究有2篇,选取了1篇;属于综合疗法的临床研究有22篇,选取了3篇。共纳入27篇,排除60篇。资料综合:①祖国医学中没有“抑郁发作”的名称。根据其临床表现,结合古代医籍,大多把它归属于中医学中的“郁病”范畴。《内经》中首先提出了情志内郁致病的思想。肝失疏泄,脾失运化,心神失养,脏腑阴阳气血失调是郁病总的发病机制。②现代学者以“行气、调中”、“调理脑神”、“调神疏肝法”为主要治则治法,还有学者采用了分期治疗的方法,即早期行气解郁、中期下气开结和后期益气宁神。③抑郁发作中医疗法主要有电针疗法、头针疗法、毫针疗法、穴位注射疗法、耳针疗法、运用针刺和中药结合心理疗法综合疗法。④近年来针灸治疗抑郁发作性心境障碍方法各异,有一定的临床疗效,但存在诊断标准不统一、不明确,针灸治疗机制研究较少,多数的临床研究缺乏规范化设计,操作方法缺乏规范等问题。结论:针灸治疗抑郁发作性心境障碍的有一定疗效,且具有副作用少、安全、经济、易被患者接受等优点。通过对针灸治疗抑郁发作进行研究,寻求一种安全、简便的治疗方法,将会在提高患者的生活质量,降低抑郁的社会经济负担方面具有重大的医学和社会意义。
OBJECTIVE： To elucidate the validity and security of treatment of depressive accession with acupuncture, and seek an effective treatment, so as to improve the compliance of patients and reduce the recurrent rate.
DATA SOURSES： A computer-based online search was conducted in China Journal Full-text Database and Wanfang database for relevant articles published from January 1999 to December 2005 with the key words of ＂depression,depressive accession, depressive neurosis, acupuncture and moxibustion, acupuncture, electroacupuncture, acupoint injection, needling with filiform needles, scalp acupuncture, ear acupuncture, treatment＂ , and the language was limited to Chinese.
STUDY SELECTION：Data were checked in the first trial, and literatures about basic theory and clinical observation of depressive accession treated with acupuncture were selected, and literatures of basic theory were generalized of points of view, while researches of non-randomized clinical experiments were excluded, and the rest literatures were looked up for the full text. Researches of randomized clinical experiments were taken as the inclusion criteria.
DATA EXTRACTION：Two articles about the depressive accession in overview were excluded. A total of 87 related articles were collected, 10 of them were basic theories,including 6 articles about the cause and pathogenesis, 3 studies of therapeutic principles and methods. Of 17 researches about the clinical research of electroacupuncture, 4 were selected. Of 10 studies ofclinical research on scalp acupuncture,2 were chosen. Of 24 clinical researches of needling with filiform needles,6 were selected. Of 2 clinical researches of acupoint injection,2 were chosen. Of 2 clinical researches of ear acupuncture, 1 was chosen. Of 22 clinical researches of combined treatment,3 were chosen. A total of 27 articles were included, and 60 were excluded.
DATA SYNTHESIS： ①In the traditional Chinese medicine, there is no conception of ＂depressive accession＂. According to the clinical representations and original books, these symptoms belong to the category of ＂depressed disease＂. The failure of liver to dredge and regulate ,the failure of the spleen to transport and transform,the failure of the heart-spirit to get the nourish,the failure of the zang-fu organs, qi-blood, yin-yang to be controlled ,are the main pathogenesis.②Nowadays, scholars used many thera- peutic principles and methods, main of them were ＂move the qi and regu-late the middle energizer＂, ＂regulate the brain and mind＂, ＂dredge the liver and regulate the mind＂. Some others used the therapeutic principles of different method according to different period, i.e. regulating qi by alleviation of mental depression in early period, keeping the adverse qi flowing downward and dissolving knot in middle period as well as benefiting qi and relieving mental stress in later period.③The major methods of depressive accession were electroacupuncture, acupoint injection, needling with filiform needles, scalp acupuncture, ear acupuncture and combined treatment of psychotherapy, acupuncture and Chinese medicine.④Study on collected articles showed that there were a good deal of therapies for depressive accession with definite therapeutic effects, while there were some problems in clinical researches： the diagnosis criterions were disunity and undefined, studies on acupuncture mechanism were not enough, most of the clinical researches lacked in standardized and the manipulations were not standard.
CONCLUSION： Acupuncture is an effectual therapy for depressive accession with less side effects and is safe, economical as well as acceptable to patients etc. To seek for a safe and convenient treatment through the investigation of treatment of depressive accession with acupuncture will enhance the quality of patient＇s life and reduce the economical burden of society from the depression.
出处
《中国临床康复》
CSCD
北大核心
2006年第27期113-115,共3页
Chinese Journal of Clinical Rehabilitation
