不同基源芥子的天灸疗法对阈下抑郁患者注意力网络的影响OA

Objective To observe the clinical effect of blistering moxibustion(tianjiu)with mustard seeds of different botanical sources on subthreshold depression(SD)and the influence on attention networks in SD patients.Methods A total of 105 SD patients were randomly allocated into a yellow mustard seeds group(35 cases),a white mustard seeds group(35 cases,2 cases were eliminated)and a placebo group(35 cases,2 cases were eliminated).In the yellow mustard seeds group and the white mustard seeds group,the Lingnan traditional tianjiu formula No.4(composed of semen sinapis,radix curcumae and fructus evodiae)was used in blistering moxibustion.In the placebo group,blistering moxibustion was delivered using placebo medicine.Two acupoint regimens were adopted alternatively in interventions.The regimen 1 included bilateral Feichu(BL13),Ganshu(BL18),Geshu(BL17),Danshu(BL19)and Zhongwan(CV12);and the regimen 2 included bilateral Pohu(BL42),Hunmen(BL47),Geguan(BL46),Yanggang(BL48)and Jianli(CV11).The acupoint application was retained for 1 h in each intervention,2 interventions a week and for consecutive 6 weeks.Separately,before treatment,in 3 and 6 weeks of treatment and in follow-up(4 weeks after treatment completion),the scores of the 9-item patient health questionnaire(PHQ-9),the generalized anxiety disorder-7(GAD-7)and the Pittsburgh sleep quality index(PSQI)were compared among groups.After the first treatment,in 48 h after 3 weeks of treatment and 6 weeks of treatment,the skin allergic reaction grade and blistering rate were assessed in each group.Before treatment and in 6 weeks of treatment,the reaction time of the attention network test(ANT)and psychomotor vigilance task(PVT)were evaluated in each group.Results In 3 and 6 weeks of treatment and in follow-up,the scores of PHQ-9,GAD-7 and PSQI were reduced in each group compared with those before treatment(P＜0.05).In the yellow mustard seeds group and the white mustard seeds group,the reduction ranges of PHQ-9 scores were larger than that in the placebo group at each time point(P＜0.05),the reduction range of PSQI score in the yellow mustard seeds group was larger in comparison with the placebo group in follow-up(P＜0.05),and the reduction ranges of GAD-7 and PSQI scores in the white mustard seeds group were larger when compared with those in the placebo group in 6 weeks of treatment and follow-up(P＜0.05).After the first treatment,the blistering rates were no statistically difference between the yellow mustard seeds group(22.9%)and the white mustard seeds group(36.3%,P＞0.05).There was not difference in clinical effect between the patients with blisters and those without blisters in each group(P＞0.05).In 6 weeks of treatment,the reaction time of alerting and executive control in ANT was elevated in comparison with that before treatment in the yellow mustard seeds group(P＜0.05),and that of PVT in the yellow mustard seeds group and white mustard seeds group was reduced when compared with that before treatment(P＜0.05).In 6 weeks of treatment,the reduction range of PVT time reaction in the white mustard seeds group was larger than that in the placebo group and the yellow mustard seeds group,respectively(P＜0.05).No systemic allergic reaction or other serious adverse events occurred in each group.Conclusion Blistering moxibustion with mustard seeds of different botanical sources effectively alleviates depression,anxiety and sleep disorder in SD patients and is safe in treatment.The yellow mustard seeds group displays the obvious improvements in the network reaction time of executive control,while the white mustard seeds shows the remarkable improvements in the vigilant attention of PVT.