电针穴位刺激厌恶疗法治疗酒依赖的临床疗效

摘要

Objective:To evaluate efficacy of electric acupuncture therapy in patients with alcohol dependence. Methods:60 male patients were recruited, were in line with ICD-10 diagnostic criteria for alcohol dependence, and volunteered to participate in this study without electric acupuncture aversion treatment contraindications. These patients were randomly divided into electric acupuncture aversion therapy group (30 cases) and control group (30 cases) by using random number table method. The two groups had no signifi-cant differences in age, sex and drinking history. Symptom check list (SCL-90) and Hamilton anxiety scale (HAMA) were used to e-valuate changes in psychological symptoms before and after the treatment, and Pennsylvania alcohol craving scale ( PACS) was used to assess the degree of craving for alcohol before and after the treatment. 1 week after hospitalization, the two groups were treated with benzodiazepine class of drug substitution therapy to relieve the patient's physical withdrawal symptoms. From the second week, the SCL-90, Hamilton anxiety scale and Pennsylvania alcohol craving scores of the two groups were recorded. Further, test group received the electric acupuncture aversion therapy for 4 weeks, while control group only took medication. After the electric acupuncture aversion therapy, the SCL-90, alcohol craving and Hamilton anxiety scale scores of the two groups were assessed. Results:(1) After the treat-ment, the SCL-90, Pennsylvania alcohol craving and Hamilton anxiety scale scores of the two groups all decreased; however, test group decreased more obviously, and the differences were: SCL-90 score (13. 242±2. 311 vs. 20. 141±3. 122, t=9. 735, P=0. 000), somatization (0. 081±0. 011 vs. 0. 122±0. 021, t=9. 789, P=0. 000), depression (0. 101±0. 021 vs. 0. 142±0. 022, t=7. 746, P=0. 000), anxiety (0. 171±0. 022 vs. 0. 231±0. 031, t=9. 115, P=0. 000), interpersonal relationship (0. 101±0. 011 vs. 0. 321±0. 021, t=7. 349, P=0. 000), Pennsylvania alcohol craving scores (4. 71±0. 54 vs. 6. 52±0. 71, t=11. 114, P=0. 000), Hamilton anxiety scale score (18. 13±4. 86 vs. 22. 17±5. 12, t=3. 135, P=0. 003)〗. (2) At the follow-up 1 year after the treat-ment, 8 cases in electric acupuncture aversion treatment group drunk again with a re-drinking rate of 26. 67%, whereas 11 cases in control group drunk again with a re-drinking rate of 36. 67%,, and the difference was insignificant. Conclusions: The electric acu-puncture aversion treatment can help to reduce drinking behavior, so that the re-drinking rate is lower.%目的：评估电针穴位刺激疗法治疗酒依赖患者的疗效。方法：60例酒依赖男性患者,均符合ICD-10酒依赖的诊断标准,自愿参加本次研究,且无电针穴位刺激厌恶治疗的禁忌证。采用随机数字表方法将患者随机分为药物加电针组30例及单纯药物组30例。两组患者在年龄、性别及饮酒史方面无显著性差异。采用症状自评量表(SCL-90)及汉密尔顿焦虑量表(HAMA)评价患者在接受治疗前后的心理症状变化。采用宾夕法尼亚酒精渴求量表( PACS)评估患者治疗前后对酒的渴求程度。住院后第1周,两组患者均接受苯二氮类药物替代治疗来解除患者的躯体戒断症状。第2周开始,两组患者均进行SCL-90、汉密尔顿焦虑量表及宾夕法尼亚酒精渴求量表评分,药物加电针组患者同时接受4周的电针穴位刺激厌恶疗法治疗,单纯药物组患者只进行药物治疗。电针治疗疗程结束后再次评估两组患者的SCL-90、饮酒渴求程度及汉密顿焦虑量表。结果：①两组患者在治疗后的SCL-90、宾夕法尼亚酒精渴求量表及汉密尔顿焦虑量表评分与治疗前相比均有所降低,但药物加电针组患者的降低更加明显：SCL-90总分差值(13.242±2.311 vs.20.141±3.122,t=9.735,P=0.000),躯体化(0.081±0.011 vs.0.122±0.021,t=9.789,P=0.000),抑郁(0.101±0.021 vs.0.142±0.022,t=7.746,P=0.000),焦虑(0.171±0.022 vs.0.231±0.031,t=9.115,P=0.000),人际关系(0.101±0.011 vs.0.321±0.021,t=7.349,P=0.000)；宾夕法尼亚酒精渴求量表评分差值比较(4.71±0.54 vs.6.52±0.71,t=11.114,P=0.000)；汉密尔顿焦虑量表评分差值比较(18.13±4.86 vs.22.17±5.12,t=3.135,P=0.003)。②治疗后1年随访中,药物加电针组有8例复饮,复饮率26.67%,单纯药物组有11例复饮,复饮率36.67%,两组患者复饮率差异不显著。结论：电针穴位刺激厌恶治疗可有助于减少饮酒行为,使复饮率倾向于更低。