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耳神门穴点压对社区老年期焦虑障碍患者焦虑症状的影响

陆啸风 吴颢 李欣馨 陈思路 薛连学 杨应环

陆啸风, 吴颢, 李欣馨, 陈思路, 薛连学, 杨应环. 耳神门穴点压对社区老年期焦虑障碍患者焦虑症状的影响[J]. 中华全科医学, 2023, 21(2): 275-278. doi: 10.16766/j.cnki.issn.1674-4152.002863
引用本文: 陆啸风, 吴颢, 李欣馨, 陈思路, 薛连学, 杨应环. 耳神门穴点压对社区老年期焦虑障碍患者焦虑症状的影响[J]. 中华全科医学, 2023, 21(2): 275-278. doi: 10.16766/j.cnki.issn.1674-4152.002863
LU Xiao-feng, WU Hao, LI Xin-xin, CHEN Si-lu, XUE Lian-xue, YANG Ying-huan. Effect of auricular Shenmen point pressure on anxiety symptoms of elderly patients with anxiety disorder in community[J]. Chinese Journal of General Practice, 2023, 21(2): 275-278. doi: 10.16766/j.cnki.issn.1674-4152.002863
Citation: LU Xiao-feng, WU Hao, LI Xin-xin, CHEN Si-lu, XUE Lian-xue, YANG Ying-huan. Effect of auricular Shenmen point pressure on anxiety symptoms of elderly patients with anxiety disorder in community[J]. Chinese Journal of General Practice, 2023, 21(2): 275-278. doi: 10.16766/j.cnki.issn.1674-4152.002863

耳神门穴点压对社区老年期焦虑障碍患者焦虑症状的影响

doi: 10.16766/j.cnki.issn.1674-4152.002863
基金项目: 

上海市长宁区科学技术委员会医疗卫生科研专项课题一般项目 CNKW2018Y24

上海市长宁区精神卫生中心院级科研项目 2019002

详细信息
    通讯作者:

    杨应环,E-mail:289877509@qq.com

  • 中图分类号: R749.72  R245.9

Effect of auricular Shenmen point pressure on anxiety symptoms of elderly patients with anxiety disorder in community

  • 摘要:   目的  探索耳神门穴点压对社区老年期广泛性焦虑障碍(GAD)的治疗效果及额叶功能的改善作用。  方法  选择2020年9月—2021年6月就诊于上海市静安区南京西路街道社区卫生服务中心及上海市长宁区精神卫生中心的老年期GAD患者90例,采用随机数字表法将患者随机分为耳穴刺激组(47例)和对照组(43例),耳穴刺激组接受耳神门穴王不留行籽点压,对照组则对耳垂部进行点压,共8周。干预前后分别采用汉密尔顿焦虑量表(HAMA)、老年焦虑量表(GAI)及额叶功能量表(FAB)进行评估。  结果  耳穴刺激组与对照组在基线时点的人口学资料、焦虑症状及额叶功能差异均无统计学意义(均P>0.05)。干预8周后,与对照组比较,耳穴刺激组的HAMA及GAI得分显著降低[(15.41±6.79)分vs. (24.32±4.96)分,(7.97±2.71)分vs. (11.99±2.87)分, 均P<0.05],而FAB得分显著升高[(10.79±3.41)分vs. (3.61±2.32)分, P<0.05]。HAMA的减分值与FAB增分值呈负相关关系(r=-0.205,P=0.006),HAMA躯体维度得分差值与GAI得分差值呈正相关关系(r=0.472,P<0.001)。  结论  耳神门穴点压对社区老年期GAD患者的焦虑症状具有显著的改善作用,其作用机制可能与额叶功能改善相关。

     

  • 表  1  耳穴刺激组与对照组患者基线时点的人口学资料比较

    Table  1.   Comparison of demographic data at baseline between patients in the ear point stimulation group and the control group

    组别 例数 年龄
    (x±s,岁)
    性别(例) 受教育年限
    (x±s,年)
    居住状况(例) 家庭年收入
    (x±s,万)
    病程
    (x±s,月)
    男性 女性 独居 同居
    耳穴刺激组 31 59.71±9.08 14 17 11.20±3.62 20 11 8.83±2.28 10.32±5.84
    对照组 33 62.67±6.42 13 20 10.57±3.35 18 15 9.08±2.80 12.47±4.16
    统计量 -1.303a 0.005b 0.816a 0.243b -0.304a -1.672a
    P 0.199 0.944 0.415 0.622 0.736 0.094
    注:at值,b为χ2值。
    下载: 导出CSV

    表  2  耳穴刺激组与对照组GAD患者基线时点的临床症状及额叶功能比较(x±s,分)

    Table  2.   Comparison of clinical symptoms and frontal lobe function of GAD patients at baseline between auricular point stimulation group and control group (x±s, points)

    组别 例数 HAMA HAMA-心理 HAMA-躯体 HAMD-17 GAI FAB
    耳穴刺激组 31 25.04±1.65 9.52±0.73 15.52±1.26 8.74±0.47 12.39±0.68 2.47±0.62
    对照组 33 24.84±1.20 10.37±0.80 13.47±0.94 6.77±0.55 12.48±0.56 2.33±0.69
    t 1.155 0.546 0.281 0.231 0.369 0.520
    P 0.254 0.585 0.780 0.818 0.714 0.606
    下载: 导出CSV

    表  3  耳穴刺激组与对照组GAD患者干预前后焦虑症状严重程度及额叶功能比较

    Table  3.   Comparison of anxiety symptom severity and frontal lobe function of GAD patients between auricular point stimulation group and control group before and after intervention

    项目 耳穴刺激组
    (x±s,分)
    对照组
    (x±s,分)
    差值估计 SE 95% CI t P F P
    HAMA
      基线 25.04±1.65 24.84±1.20 1.263 0.374 0.273~2.253 0.864 0.393 30.157 < 0.001
      2周末 22.89±9.76 24.03±10.69 -1.570 0.512 -2.925~-0.215 -0.932 0.412
      4周末 19.97±10.68 23.56±8.40 -3.426 0.733 -5.365~-1.487 -2.221 0.027
      6周末 18.26±9.37 23.04±9.89 -5.139 1.385 -8.803~-1.475 -3.118 0.004
      8周末 15.41±6.79 24.32±4.96 -7.836 1.816 -12.641~-3.031 -5.472 < 0.001
    HAMA-心理
      基线 9.52±0.73 10.37±0.80 -0.351 0.104 -0.626~-0.076 -0.528 0.427 10.434 0.033
      2周末 8.16±2.43 9.97±4.12 -1.247 0.383 -2.260~-0.234 -0.739 0.128
      4周末 7.95±4.16 9.63±3.58 -1.546 0.412 -2.636~-0.456 -1.624 0.461
      6周末 7.70±3.41 9.50±2.46 -1.810 0.456 -3.016~-0.604 -1.686 0.092
      8周末 7.05±2.79 9.51±2.10 -2.194 0.517 -3.562~-0.826 -1.748 0.047
    HAMA-躯体
      基线 15.52±1.26 13.47±0.94 1.047 0.227 0.446~1.648 0.911 0.361 28.679 < 0.001
      2周末 12.77±3.64 13.95±5.41 -1.801 0.047 -1.925~-1.677 -1.432 0.097
      4周末 10.92±4.12 13.61±6.30 -3.637 0.115 -3.941~-3.333 -2.915 0.036
      6周末 8.79±3.91 13.55±3.19 -5.583 0.629 -7.247~-3.919 -4.030 0.008
      8周末 6.47±3.70 13.65±2.47 -7.037 0.902 -9.423~-4.651 -5.942 < 0.001
    GAI
      基线 12.39±0.68 12.48±0.56 -0.154 0.020 -0.207~-0.101 -0.160 0.517 31.526 < 0.001
      2周末 10.17±3.14 11.94±4.75 -2.206 0.471 -3.452~-0.960 -1.975 0.044
      4周末 9.84±4.10 11.50±5.94 -2.831 0.759 -4.839~-0.823 -2.371 0.029
      6周末 8.10±3.76 11.78±3.60 -3.372 0.834 -5.579~-1.165 -2.858 0.014
      8周末 7.97±2.71 11.99±2.87 -3.910 1.391 -7.590~-0.230 -3.126 0.008
    FAB
      基线 2.47±0.62 2.33±0.69 1.316 0.336 0.644~1.988 0.744 0.155 15.710 0.004
      8周末 10.79±3.41 3.61±2.32 6.132 1.570 2.992~9.272 4.691 < 0.001
    下载: 导出CSV
  • [1] HUANG Y Q, WANG Y, WANG H, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study[J]. Lancet Psychiat, 2019, 6(3): 211-224. doi: 10.1016/S2215-0366(18)30511-X
    [2] 王春燕, 张学平. 焦点解决模式对老年焦虑障碍共病高血压患者的心理护理作用[J]. 中华全科医学, 2020, 18(10): 1779-1782. doi: 10.16766/j.cnki.issn.1674-4152.001617

    WANG C Y, ZHANG X P. Psychological nursing effect of the solution-focused model on elderly patients with hypertension and generalized anxiety disorder[J]. Chinese Journal of General Practice, 2020, 18(10): 1779-1782. doi: 10.16766/j.cnki.issn.1674-4152.001617
    [3] 范曼丽, 魏裕涛, 魏佳娜, 等. 基于数据挖掘的针灸治疗焦虑症经穴运用规律分析[J]. 中国中医基础医学杂志, 2019, 25(3): 357-360. doi: 10.19945/j.cnki.issn.1006-3250.2019.03.022

    FAN M L, WEI Y T, WEI J N, et al. Law of meridian and acupoint selection in acupuncture treatment for anxiety based on data-mining method[J]. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 2019, 25(3): 357-360. doi: 10.19945/j.cnki.issn.1006-3250.2019.03.022
    [4] 陈默, 梁碧. 耳穴贴压疗法辅助治疗肝火扰心型亚健康失眠的临床研究[J]. 中国基层医药, 2021, 28(3): 335-339. doi: 10.3760/cma.j.issn.1008-6706.2021.03.004

    CHEN M, LIANG B. Clinical study on auricular plaster therapy in the auxiliary treatment of insomnia caused by liver fire disturbance in a sub-healthy population[J]. Chinese Journal of Primary Medicine and Pharmacy, 2021, 28(3): 335-339. doi: 10.3760/cma.j.issn.1008-6706.2021.03.004
    [5] GOH W Y, CHAN D, ALI N B, et al. Frontal assessment battery in early cognitive impairment: psychometric property and factor structure[J]. J Nutr Health Aging, 2019, 23(10): 966-972. doi: 10.1007/s12603-019-1248-0
    [6] 美国精神医学学会. 精神障碍诊断与统计手册(第五版)[M]. 北京: 北京大学出版社, 2016.

    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition)[M]. Beijing: Peking University Press, 2016.
    [7] ZIMMERMAN M, MARTIN J, CLARK H, et al. Measuring anxiety in depressed patients: a comparison of the Hamilton anxiety rating scale and the DSM-5 Anxious Distress Specifier Interview[J]. J Psychiatr Res, 2017, 93: 59-63. doi: 10.1016/j.jpsychires.2017.05.014
    [8] MOLDE H, NORDHUS I H, TORSHEIM T, et al. A cross-national analysis of the psychometric properties of the geriatric anxiety inventory[J]. J Gerontol B Psychol Sci Soc Sci, 2020, 75(7): 1475-1483. doi: 10.1093/geronb/gbz002
    [9] 程锦, 程文炜, 刘晓芳, 等. 层次结构数据的分析方法及SPSS实现[J]. 中华老年医学杂志, 2020, 39(10): 1236-1240. doi: 10.3760/cma.j.issn.0254-9026.2020.10.030

    CHENG J, CHENG W W, LIU X F, et al. Analyzing methods of hierarchically structured data and its implementation in SPSS Statistics[J]. Chinese Journal of Geriatrics, 2020, 39(10): 1236-1240. doi: 10.3760/cma.j.issn.0254-9026.2020.10.030
    [10] RAIJ T, NUMMENMAA A, MARIN M F, et al. Prefrontal cortex stimulation enhances fear extinction memory in humans[J]. Biol Psychiatry, 2018, 84(2): 129-137. doi: 10.1016/j.biopsych.2017.10.022
    [11] 赵奎, 张梅刃, 曾啸, 等. 耳穴压豆疗法对老年髋部骨折患者术后谵妄、睡眠时间及焦虑水平的影响[J]. 现代生物医学进展, 2021, 21(12): 2386-2390. doi: 10.13241/j.cnki.pmb.2021.12.041

    ZHAO K, ZHANG M R, CENG X, et al. Effect of auricular acupoint pressing therapy on postoperative delirium, sleep time and anxiety level of elderly patients with hip fracture[J]. Progress in Modern Biomedicine, 2021, 21(12): 2386-2390. doi: 10.13241/j.cnki.pmb.2021.12.041
    [12] 潘子彦, 黄峰, 许荣梅. 心理疏导法并耳穴刺激治疗老年焦虑症的疗效[J]. 中国老年学杂志, 2017, 37(22): 5666-5667. doi: 10.3969/j.issn.1005-9202.2017.22.083

    PAN Z Y, HUANG F, XU R M. Psychotherapy and auricular stimulation in the treatment of senile anxiety[J]. Chinese Journal of Gerontology, 2017, 37(22): 5666-5667. doi: 10.3969/j.issn.1005-9202.2017.22.083
    [13] 杨丽华, 段培蓓, 侯庆梅, 等. 耳穴贴压干预成年患者焦虑的Meta分析[J]. 中华现代护理杂志, 2019, 25(26): 3337-3342. doi: 10.3760/cma.j.issn.1674-2907.2019.26.008

    YANG L H, DUAN P B, HOU Q M, et al. Meta-analysis of auricular-plaster therapy intervening with anxiety in adults[J]. Chinese Journal of Modern Nursing, 2019, 25(26): 3337-3342. doi: 10.3760/cma.j.issn.1674-2907.2019.26.008
    [14] 袁丹丹, 周静, 吴宁宁, 等. 个体化心理辅导联合耳穴压豆对产褥期产妇焦虑和抑郁的干预效果[J]. 中华全科医学, 2021, 19(9): 1539-1541, 1568. doi: 10.16766/j.cnki.issn.1674-4152.002106

    YUAN D D, ZHOU J, WU N N, et al. Intervention effect of individualised psychological counselling combined with ear acupoint pressing on anxiety and depression during puerperium[J]. Chinese Journal of General Practice, 2021, 19(9): 1539-1541, 1568. doi: 10.16766/j.cnki.issn.1674-4152.002106
    [15] BUTT M F, ALBUSODA A, FARMER A D, et al. The anatomical basis for transcutaneous auricular vagus nerve stimulation[J]. J Anat, 2020, 236(4): 588-611. doi: 10.1111/joa.13122
    [16] MATHEW E, TABET M N, ROBERTSON N M, et al. Vagus nerve stimulation produces immediate dose-dependent anxiolytic effect in rats[J]. J Affect Disord, 2020, 265: 552-557. doi: 10.1016/j.jad.2019.11.090
    [17] NOBLE L J, CHUAH A, CALLAHAN K K, et al. Peripheral effects of vagus nerve stimulation on anxiety and extinction of conditioned fear in rats[J]. Learn Mem, 2019, 26(7): 245-251. doi: 10.1101/lm.048447.118
    [18] BADRAN B W, DOWDLE L T, MITHOEFER O J, et al. Neurophysiologic effects of transcutaneous auricular vagus nerve stimulation (taVNS) via electrical stimulation of the tragus: a concurrent taVNS/fMRI study and review[J]. Brain Stimul, 2018, 11(3): 492-500. doi: 10.1016/j.brs.2017.12.009
    [19] CUI H R, ZHANG B, LI W, et al. Insula shows abnormal task-evoked and resting-state activity in first-episode drug-nave generalized anxiety disorder[J]. Depress Anxiety, 2020, 37(7): 632-644. doi: 10.1002/da.23009
    [20] CARLINO E, PIEDIMONTE A, BENEDETTI F. Nature of the placebo and nocebo effect in relation to functional neurologic disorders[J]. Handb Clin Neurol, 2016, 139: 597-606.
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  • 收稿日期:  2022-03-07
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