Effect of transcutaneous electrical stimulation of acupoints in patients with alcohol dependence
-
摘要:目的
观察经皮穴位电刺激在酒精依赖患者心理渴求和稽延性戒断症状中的应用效果。
方法选取在湖南省脑科医院酒瘾科住院的120例酒精依赖完成急性脱瘾期的男性患者为研究对象，根据患者治疗方式的不同分为常规药物组、经皮穴位电刺激组及假刺激组，每组40例。常规药物组采用苯二氮䓬类药物替代递减以及支持性对症治疗，经皮穴位电刺激组采用常规治疗联合经皮穴位电刺激，假刺激组采用常规治疗联合模拟经皮穴位电刺激。比较3组患者治疗前后焦虑自评量表(SAS)评分及抑郁自评量表(SDS)评分、饮酒迫切性量表(AUQ)评分、视觉模拟评分法(VAS)评分、匹兹堡睡眠质量指数(PSQI)评分及复发情况。
结果治疗后, 3组患者SAS、SDS、AUQ及VAS评分均较治疗前降低，且经皮穴位电刺激组以上评分均低于常规药物组及假刺激组，差异有统计学意义(P < 0.05)。治疗后，3组患者睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍评分及PSQI总分均低于治疗前，且经皮穴位电刺激组以上评分均低于常规药物组及假刺激组，差异有统计学意义(P < 0.05)。经皮穴位电刺激组复发率低于常规药物组及假刺激组，差异有统计学意义(P < 0.05)。
结论相较于常规治疗及模拟经皮电刺激，经皮穴位电刺激治疗更有利于减轻患者焦虑、抑郁及失眠等稽延性戒断症状严重程度，并利于降低患者心理渴求程度，从而降低复发率。
Abstract:ObjectiveTo observe the application effect of transcutaneous acupoint electrical stimulation in the psychological craving and protracted abstinence symptoms of alcohol-dependent patients.
MethodsA total of 120 male alcohol-dependent patients who completed the acute alcohol withdrawal phase and were hospitalized in the Department of Alcoholism in Hunan Brain Hospital were selected as the study subjects. They were divided into conventional drug group, transcutaneous acupoint electrical stimulation group and placebo group according to different treatment methods, with 40 patients in each group. The conventional drug group was treated with benzodiazepine drugs for replacement and reduction and supportive symptomatic treatment. The transcutaneous acupoint electrical stimulation group was treated with conventional treatment combined with transcutaneous acupoint electrical stimulation. The placebo group was treated with conventional treatment combined with simulated transcutaneous acupoint electrical stimulation. The Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Alcohol Urge Questionnaire (AUQ), Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI) score and recurrence conditions were compared before and after treatment among the three groups.
ResultsAfter treatment, the SAS, SDS, AUQ and VAS scores of the three groups were lower than those before treatment, and the above scores of the transcutaneous acupoint electrical stimulation group were lower than those of the conventional drug group and placebo group (P < 0.05). After treatment, the scores of sleep quality, the time to fall asleep, sleep duration, sleep efficiency, sleep disturbance, hypnotic drugs, daytime dysfunction and total PSQI score of the three groups were lower than those before treatment, and the above scores of the transcutaneous acupoint electrical stimulation group were lower than those of the conventional drug group and placebo group (P < 0.05). The recurrence rate of the transcutaneous acupoint electrical stimulation group was lower than that of the conventional drug group and placebo group (P < 0.05).
ConclusionCompared with conventional treatment and simulated transcutaneous electrical stimulation, transcutaneous acupoint electrical stimulation is more effective in reducing the severity of protracted abstinence symptoms such as anxiety, depression and insomnia, and is also beneficial in reducing patients' psychological craving, thereby reducing the recurrence rate.
-
-
表 1 3组患者治疗前后焦虑及抑郁程度比较(x±s)
分 组别 焦虑自评量表评分 抑郁自评量表评分 治疗前 治疗后 治疗前 治疗后 假刺激组(n=40) 56.20±5.37 45.23±3.72*# 51.90±4.37 43.73±3.52*# 经皮穴位电刺激组(n=40) 55.45±5.72 37.48±2.86* 52.13±4.08 36.18±3.19* 常规药物组(n=40) 55.83±6.00 45.60±3.46*# 52.23±4.15 44.00±3.40*# 与治疗前比较, * P < 0.05; 与经皮穴位电刺激组比较, #P < 0.05。 
下载: 导出CSV
表 2 3组患者治疗前后饮酒迫切程度及心理渴求程度比较(x±s)
分 组别 饮酒迫切性量表评分 视觉模拟评分法评分 治疗前 治疗后 治疗前 治疗后 假刺激组(n=40) 27.65±3.03 17.15±2.37*# 5.20±1.07 3.93±0.86*# 经皮穴位电刺激组(n=40) 27.25±2.98 14.23±2.03* 5.10±1.01 2.75±0.74* 常规药物组(n=40) 27.48±2.99 17.20±2.28*# 5.18±0.98 3.88±0.88*# 与治疗前比较, * P < 0.05; 与经皮穴位电刺激组比较, #P < 0.05。
下载: 导出CSV
表 3 3组患者治疗前后睡眠质量情况比较(x±s)
分 项目 时点 假刺激组(n=40) 经皮穴位电刺激组(n=40) 常规药物组(n=40) 睡眠质量 治疗前 2.33±0.47 2.35±0.48 2.33±0.53 治疗后 2.00±0.23*# 1.78±0.42* 2.03±0.28*# 入睡时间 治疗前 2.13±0.33 2.15±0.36 2.10±0.38 治疗后 1.98±0.16*# 1.58±0.50* 1.95±0.22*# 睡眠时间 治疗前 2.25±0.44 2.38±0.49 2.25±0.49 治疗后 1.73±0.45*# 1.40±0.50* 1.80±0.52*# 睡眠效率 治疗前 2.43±0.50 2.40±0.50 2.40±0.55 治疗后 1.93±0.42*# 1.50±0.51* 1.95±0.45*# 睡眠障碍 治疗前 2.55±0.50 2.50±0.51 2.50±0.55 治疗后 1.85±0.36*# 1.65±0.48* 1.88±0.40*# 催眠药物 治疗前 2.33±0.53 2.30±0.46 2.33±0.57 治疗后 1.68±0.47*# 1.23±0.42* 1.73±0.51*# 日间功能障碍 治疗前 2.68±0.47 2.68±0.48 2.65±0.48 治疗后 1.68±0.47*# 1.15±0.36* 1.70±0.52*# 总分 治疗前 16.68±1.42 16.73±1.09 16.55±1.22 治疗后 12.83±0.87*# 10.28±0.96* 13.03±1.00*# 与治疗前比较, * P < 0.05; 与经皮穴位电刺激组比较, #P < 0.05。
下载: 导出CSV
-
[1] 许泽平, 洪柳芝, 谢龙腾, 等. 焦虑和行动冲动性对男性酒精依赖患者攻击行为的影响[J]. 现代实用医学, 2022, 34(6): 742-744. [2] 代悠然, 陈颖, 邓红. 某大型三甲医院住院精神病患者疾病诊断变化的研究[J]. 川北医学院学报, 2020, 35(2): 216-219. doi: 10.3969/j.issn.1005-3697.2020.02.010 [3] ARIAS F, SION A, ESPINOSA R, et al. Psychological recovery stages of alcohol dependent patients after an intensive outpatient treatment: a 4-year follow-up study[J]. Adicciones, 2023, 35(1): 21-32.
[4] 胡楠楠, 王卓, 盘圣明, 等. 重复经颅磁刺激治疗酒精依赖患者情绪及渴求疗效的Meta分析[J]. 临床精神医学杂志, 2022, 32(3): 202-205. [5] BOGENSCHUTZ M P, ROSS S, BHATT S, et al. Percentage of heavy drinking days following psilocybin-assisted psychotherapy vs placebo in the treatment of adult patients with alcohol use disorder: a randomized clinical trial[J]. JAMA Psychiatry, 2022, 79(10): 953-962. doi: 10.1001/jamapsychiatry.2022.2096
[6] 罗银利, 周亚男, 杨栋, 等. 经皮穴位电刺激对气郁质甲基苯丙胺依赖者戒断后焦虑抑郁情绪及心理渴求的影响[J]. 中医药导报, 2021, 27(3): 58-61. [7] HEDEGAARD H, JOHNSON R L, WARNER M, et al. Proposed framework for presenting injury data using the international classification of diseases, tenth revision, clinical modification (ICD-10-CM) diagnosis codes[J]. Natl Health Stat Report, 2016(89): 1-20.
[8] 黄乾坤, 陆俊颖, 赵静. 结构式团体心理健康治疗对精神分裂症住院患者抑郁、焦虑情绪的影响分析[J]. 中国健康教育, 2022, 38(7): 662-666. [9] 蔡海鹏, 杜若南, 李伟, 等. 冲动、渴求对男性酒精依赖患者复饮的影响[J]. 中国药物依赖性杂志, 2023, 32(2): 155-159, 164. [10] 陈星星, 杨梅. 线索暴露结合数数法降低酒精依赖患者线索诱发渴求: 一项预实验[J]. 中国药物依赖性杂志, 2021, 30(4): 264-268. [11] 陈少鹏, 李秀芩, 邵伟华, 等. 老年慢性心力衰竭患者血浆miR-423-5p、miR-499-5p、miR-210-3p水平与其营养状况和睡眠质量的相关性[J]. 中南医学科学杂志, 2022, 50(6): 869-872. [12] 王晓娇, 申变红. 失眠认知行为疗法对酒精依赖患者睡眠质量及情绪的影响[J]. 中华全科医学, 2020, 18(2): 318-321. [13] HAREL M, PERINI I, KÄMPE R, et al. Repetitive transcranial magnetic stimulation inAlcohol dependence: a randomized, double-blind, sham-controlled proof-of-concept trial targeting the medial prefrontal andAnterior cingulate cortices[J]. Biol Psychiatry, 2022, 91(12): 1061-1069. doi: 10.1016/j.biopsych.2021.11.020
[14] 王晓丝, 岳建新, 栗雪琪, 等. 营养不良通用筛查工具对酒精依赖住院患者营养不良风险的评估[J]. 实用临床医药杂志, 2021, 25(5): 30-32, 44. doi: 10.7619/jcmp.20200909 [15] SALLAM H S, LI H X, CHEN J D Z. The effects of electroacupuncture via chronically implanted electrodes on alcohol drinking and withdrawal signs in rats[J]. Neuromodulation, 2022, 25(8): 1387-1392. doi: 10.1111/ner.13377
[16] MEINHARDT M W, GIANNONE F, HIRTH N, et al. Disrupted circadian expression of β-arrestin 2 affects reward-related μ-opioid receptor function in alcohol dependence[J]. J Neurochem, 2022, 160(4): 454-468. doi: 10.1111/jnc.15559
[17] 孔璟怡, 梁艳, 俞捷, 等. 针刺治疗毒品成瘾临床应用浅析[J]. 河南中医, 2022, 42(1): 142-146. [18] 罗菊芬, 朱永铭, 廖华萍, 等. 经皮穴位电刺激对甲基苯丙胺依赖者稽延期戒断症状的影响[J]. 中国民族民间医药, 2019, 28(20): 69-72. [19] BROOKS A T, KAZMI N, YANG L, et al. Sleep-related cognitive/behavioral predictors of sleep quality and relapse in individuals with alcohol use disorder[J]. Int J Behav Med, 2021, 28(1): 73-82. doi: 10.1007/s12529-020-09901-9
计量
- 文章访问数: 133
- HTML全文浏览量: 21
- PDF下载量: 10
苏公网安备 32100302010246号