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

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

陆啸风^{1, 2, 3},
吴颢⁴,
李欣馨^{1, 2, 3},
陈思路^{1, 2, 3},
薛连学^{1, 2, 3},
杨应环^{1, 2, 3, ,}

1.
华东师范大学附属精神卫生中心，上海 200335
2.
华东师范大学心理与认知科学学院，上海 200062
3.
上海市长宁区精神卫生中心，上海 200335
4.
上海市静安区南京西路街道社区卫生服务中心，上海 200041

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
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- 文章访问数: 157
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- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2022-03-07
- 网络出版日期: 2023-04-20

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

LU Xiao-feng^{1, 2, 3},
WU Hao⁴,
LI Xin-xin^{1, 2, 3},
CHEN Si-lu^{1, 2, 3},
XUE Lian-xue^{1, 2, 3},
YANG Ying-huan^{1, 2, 3
, ,}

1.
Affiliated Mental Health Center, East China Normal University, Shanghai 200335, China

摘要

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。
- 耳穴点压 /
- 焦虑症 /
- 躯体化症状 /
- 额叶功能
Abstract: Objective This study aims to explore the effect of auricular Shenmen point pressure on generalised anxiety disorder (GAD) and the improvement of frontal lobe function in elderly people in community. Methods Between September 2020 and June 2021 in Jing' an district of Shanghai West Nanjing Road community health service centre and Changning district of Shanghai Mental Health Centre, 90 elderly patients with GAD were recruited and randomly divided into auricular point pressure (AP) group (n=47) and control group (n=43) by random number table. The AP group accepted the 8-week seed point pressure at the ear Shenmen acupoint. The Hamilton Anxiety Scale (HAMA) and Geriatric Anxiety Inventory (GAI) were used before and after intervention, respectively. Frontal assessment battery (FAB) was evaluated in the assessment of frontal lobe. Results No significant differences in demographic data, anxiety symptoms and frontal lobe function were found between AP and control groups at baseline (all P>0.05). After 8-week intervention, the HAMA and GAI scores in the AP group were significantly lower than the control group [(15.41±6.79) points vs. (24.32±4.96) points, (7.97±2.71) points vs. (11.99±2.87) points, both P < 0.05], while the FAB scores significantly increased [(10.79±3.41) points vs. (3.61±2.32) points, P < 0.05] compared with those in the control group. The decreasing score of HAMA was negatively correlated with the increasing score of FAB (r=-0.205, P=0.006). The decrease in the HAMA somatic dimension score was positively correlated with the increase in the GAI score (r=0.472, P < 0.001). Conclusion Auricular point pressure at Shenmen point can significantly improve anxiety symptoms in elderly patients with GAD in community, and its mechanism of action may be related to improvement of frontal lobe function.
- Auricular point pressure /
- Anxiety /
- Somatisation symptoms /
- Frontal lobe function

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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)
组别	例数	年龄 (x±s，岁)	男性	女性	受教育年限 (x±s，年)	独居	同居	家庭年收入 (x±s，万)	病程 (x±s，月)
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		-1.303^a	0.005^b		0.816^a	0.243^b		-0.304^a	-1.672^a
P值		0.199	0.944		0.415	0.622		0.736	0.094
注：^a为t值，^b为χ²值。

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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值		1.155	0.546	0.281	0.231	0.369	0.520
P值		0.254	0.585	0.780	0.818	0.714	0.606

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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值	P值	F值	P值
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

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