摘要
目的探讨癔球症患者临床精神心理学特征和经皮穴位电刺激(TEAS)少商穴治疗癔球症的疗效。方法选取2017年9月至2019年6月于广州市第一人民医院南沙医院、广东省第二人民医院、贵州医科大学附属医院耳鼻喉科及消化内科门诊就诊的60例癔球症患者,按随机数字表法分为对照组(n=30)和少商穴组(n=30),采用适宜强度的电流刺激少商穴组患者,每天2次,每次30 min;采用适宜强度的电流刺激对照组患者少商穴位旁1~2 cm的非经络体表位置,每天2次,每次30 min,疗程均为4周。采用癔球症症状评分(GETS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)及匹兹堡睡眠质量指数(PSQI)对患者进行治疗前和治疗4周后的疗效评估。结果60例癔球症患者中,发现60.00%(36/60)的患者伴发睡眠障碍,65.00%(39/60)的患者伴发焦虑,35.00%(21/60)的患者伴发抑郁。经4周治疗后,对照组GETS、PSQI、HAMA、HAMD评分[(16.37±4.94)分,(12.37±7.51)分,(9.80±6.19)分,(10.67±7.63)分]与治疗前[(20.50±5.26)分,(14.53±6.80)分,(12.63±6.53)分,(12.60±8.43)分]比较,均差异有统计学意义(t=3.98,3.28,4.59,2.28;均P<0.05);少商穴组治疗后GETS、PSQI、HAMA、HAMD评分[(12.43±3.79)分,(8.50±6.76)分,(9.07±6.52)分,(8.47±6.72)分]与治疗前比较[(22.27±5.16)分,(13.43±7.30)分,(15.33±6.51)分,(13.97±4.99)分],均差异有统计学意义(t=8.44,6.93,7.49,5.77;均P<0.05);少商穴组各评分的下降程度ΔGETS、ΔPSQI、ΔHAMA、ΔHAMD[(6.49±6.38)分、(3.44±3.85)分、(4.60±4.59)分、(3.47±5.22)分]大于对照组[(2.93±4.04)分,(2.17±3.62)分,(2.83±3.38)分,(1.93±4.11)分],均差异有统计学意义(t=5.04,2.80,3.30,2.94;均P<0.05)。同时,少商穴组较对照组GETS评分[66.67%(20/30),20.00%(6/30)]、PSQI评分[63.33%(19/30),23.33%(7/30)]、HAMA评分[66.67%(20/30),30.00%(9/30)]、HAMD评分[60.00%(18/30),26.67%(8/30)]治疗的有效率高,均差异有统计学意义(χ2=13.30,9.77,7.28,6.79;均P<0.05)。结论癔球症患者多伴有睡眠障碍、焦虑状态和抑郁状态,少商穴TEAS治疗可有效改善癔球症患者的症状、睡眠障碍、焦虑和抑郁状态。
ObjectiveTo investigate the clinical psychopsychological characteristics of patients with globus pharyngeus and the therapeutic effect of transcutaneous electrical acupoint stimulation(TEAS)at Shaoshang acupoint.MethodsA total of 60 patients from September 2017 to June 2019 in the Otolaryngology and Gastroenterology Department of the Nansha Hospital of Guangzhou First People′s Hospital,the Guangdong Second Provincial General Hospital and the Affiliated Hospital of Guizhou Medical University were selected.The random number table method was used to divide the patients into control group(n=30)and Shaoshang acupoint group(n=30).With the treatment for 4 weeks,Shaoshang acupoint group was asked to stimulate Shaoshang acupoint with the current of appropriate strength,twice a day,30 min each time,while control group was asked to stimulate non-meridian body surface position of 1-2 cm off the Shaoshang acupoint.The scores of Glasgow Edinburgh throat scale(GETS),Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)and Pittsburgh sleep quality index(PSQI)were evaluated before and after 4 weeks treatment.ResultsAmong the 60 patients with globus pharyngeus,60.00%(36/60)were found to have sleep disorders,65.00%(39/60)with anxiety,and 35.00%(21/60)with depression.After treatment,the scores of GETS,PSQI,HAMA and HAMD in the control group[(16.37±4.94),(12.37±7.51),(9.80±6.19),(10.67±7.63)]were compared with those before treatment[(20.50±5.26),(14.53±6.80),(12.63±6.53),(12.60±8.43)],the differences were statistically significant(t=3.98,3.28,4.59,2.28,all P<0.05).The scores of GETS,PSQI,HAMA and HAMD 4 weeks after treatment of Shaoshang acupoint group[(12.43±3.79),(8.50±6.76),(9.07±6.52),(8.47±6.72)]were compared with those before treatment[(22.27±5.16),(13.43±7.30),(15.33±6.51),(13.97±4.99)],the differences were statistically significant(t=8.44,6.93,7.49,5.77,all P<0.05).The decreased scores of GETS,PSQI,HAMA and HAMD in the Shaoshang acupoint group before and after treatment[(6.49±6.38),(3.44±3.85),(4.60±4.59),(3.47±5.22)]were greater than those in the control group[(2.93±4.04),(2.17±3.62),(2.83±3.38),(1.93±4.11)],and the differences were statistically significant(t=5.04,2.80,3.30,2.94,all P<0.05).Meanwhile,the effective rates of treatment in Shaoshang acupoint group on GETS score[66.67%(20/30),20.00%(6/30)],PSQI score[63.33%(19/30),23.33%(7/30)],HAMA score[66.67%(20/30),30.00%(9/30)],and HAMD score[60.00%(18/30),26.67%(8/30)]were significantly higher than those of the control group,with statistically significant differences(χ2=13.30,9.77,7.28,6.79,all P<0.05).ConclusionsGlobus pharyngeus are often accompanied with sleep disorders,anxiety and depression.Shaoshang acupoint treated by TEAS can effectively improve the symptoms,sleep disorders,anxiety and depression of globus pharyngeus.
作者
何梓健
贾林
邓祺
赵寒冰
孟默
郭婉薇
He Zijian;Jia Lin;Deng Qi;Zhao Hanbing;Meng Mo;Guo Wanwei(Department of Gastroenterology, the First People′s Hospital Affiliated to Guangzhou Medical University, Guangzhou 510180, China;Department of Gastroenterology, Guangzhou First People′s Hospital, Guangzhou 510180, China;Department of Gastroenterology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550025, China;Department of Gastroenterology, Guangdong Second Provincial General Hospital, Guangzhou 510180, China)
出处
《中华诊断学电子杂志》
2020年第2期130-134,共5页
Chinese Journal of Diagnostics(Electronic Edition)
关键词
癔球症
焦虑
抑郁
睡眠障碍
经皮穴位电刺激
Globus pharyngeus
Anxiety
Depression
Sleep disorders
Transcutaneous electrical acupoint stimulation
