灵龟八法开穴针刺治疗阈下焦虑抑郁肝郁化火证的研究OA
Treatment of Subthreshold Anxiety and Depression with Liver Deression Transforming into Fire Syndrome Appling the Linggui Bafa Acupoint-Opening Method
目的:观察灵龟八法开穴针刺治疗阈下焦虑抑郁肝郁化火证的临床疗效.方法:将 60 例阈下焦虑抑郁肝郁化火证患者采用随机数字表法分为治疗组和对照组,每组 30 例.对照组给予常规针刺[选取百会、印堂、合谷(双侧)、太冲(双侧)]治疗.治疗组先给予灵龟八法开穴针刺(根据患者就诊时间推算取穴:列缺、照海、内关、外关、公孙、申脉、后溪、足临泣)治疗,开穴与配穴固定配伍关系为公孙配内关、足临泣配外关、后溪配申脉、列缺配照海,针刺操作时先刺推算所得开穴,再刺其对应配穴;随后采用常规针刺治疗,方法同对照组.两组均每周治疗 3 次,共治疗 4 周,并于治疗结束 1、3 个月各进行 1 次电话随访.对比两组汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分.结果:治疗结束 HAMD 疗效方面,治疗组临床控制 7 例,显著进步 19 例,进步 2 例,无效 2 例,有效率为 93.33%(28/30);对照组临床控制 3 例,显著进步14 例,进步 9 例,无效 4 例,有效率为 86.67%(26/30).两组疗效对比,差异有统计学意义(P<0.05).治疗结束HAMA 疗效方面,治疗组临床控制 9 例,显著进步 17 例,进步 2 例,无效 2 例,有效率为 93.33%(28/30);对照组临床控制 4 例,显著进步 11 例,进步 7 例,无效 8 例,有效率为 73.33%(22/30).两组疗效对比,差异有统计学意义(P<0.01).治疗 2、4 周及治疗结束 1、3 个月随访,治疗组 HAMD 评分、HAMA 评分均低于同期对照组(P<0.05).治疗结束 3 个月随访 HAMD 疗效方面,治疗组临床控制 7 例,显著进步 16 例,进步 0 例,无效 7 例,有效率为 76.67%(23/30);对照组临床控制 1 例,显著进步 7 例,进步 6 例,无效 16 例,有效率为 46.67%(14/30).两组疗效对比,差异有统计学意义(P<0.01).3 个月随访 HAMA 疗效方面,治疗组临床控制 4 例,显著进步 14 例,进步 5 例,无效 7 例,有效率为 76.67%(23/30);对照组临床控制 1 例,显著进步 3 例,进步 9 例,无效 17 例,有效率为 43.33%(13/30).两组疗效对比,差异有统计学意义(P<0.01).结论:灵龟八法开穴针刺可缓解阈下焦虑抑郁肝郁化火证患者的焦虑、抑郁症状,疗效持久,体现了中医学因时制宜及天人合一的整体调节优势.
Objective:To observe the clinical efficacy of Linggui Bafa acupoint-opening method in treatment of subthreshold anxiety and depression with liver depression transforming into fire syndrome.Methods:A total 60 patients with subthreshold anxiety and depression of liver depression transforming into fire syndrome were randomly divided into a treatment group and a control group using a random number table,with 30 cases in each group.The patients in control group were treated with conventional acupuncture at Baihui(GV20),Yintang(EX-HN3),bilateral Hegu(LI4),and bilateral Taichong(LR3).The patients in treatment group were treated with Linggui Bafa acupoint-opening method firstly.The opening points were speculated as Lieque LU7,Zhaohai KI6,Neiguan PC6,Waiguan TE5,Gongsun SP4,Shenmai BL62,Houxi SI3,and Zu Lingqiao GB41 according to the treatment time.The opening points and their associated points were fixed as following:Gongsun with Neiguan,Zu Lingqiao with Waiguan,Houxi with Shenmai,and Lieque with Zhaohai.After the opening points were punctured,their associated points and conventional acupuncture points were punctured consecutively.The patients in both groups were treated three times per week for a total of 4 weeks,with 1-month and 3-month telephone follow-up.The Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)scores in both groups were compared.Results:After treatment,the HAMD scores of 7 cases in treatment group showed clinical control,19 marked obvious improvement,2 improvement,and 2 cases of null and void,with an efficient rate of 93.33%(28/30),with 3,14,9,and 4 cases in control group respectively,and the efficient rate was 86.67%(26/30).There was efficacy difference between the HAMD scores of treatment group and control group(P<0.05).The HAMA scores of 9 cases in treatment group showed clinical control,17 marked obvious improvement,2 improvement,and 2 cases of null and void,with an efficient rate of 93.33%(28/30),and 4,11,7,and 8 cases in control group respectively,with an efficient rate of 73.33%(22/30).There was efficacy difference between the HAMA scores of treatment group and control group(P<0.01).The scores of HAMD and HAMA in treatment group after treated 2 or 4 weeks and the scores of 1-month or 3-month follow-ups were lower than the corresponding scores of control group(P<0.05).In 3-month of follow-up,HAMD scores of 7 cases in treatment group showed clinical control,16 marked obvious improvement,0 improvement,and 7 cases of null and void,with an efficient rate of 76.67%(23/30),and 1,7,6,and 16 cases in control group respectively,with an efficient rate of 46.67%(14/30).There was efficacy difference between the HAMD scores of treatment group and control group(P<0.01).In 3-month of follow-up,HAMA scores of 4 cases in treatment group showed clinical control,14 marked obvious improvement,5 improvement,and 7 cases of null and void,with an efficient rate of 76.67%(23/30),and 1,3,9,and 17 cases in control group respectively,with an efficient rate of 43.33%(13/30).There was efficacy difference between the HAMA scores of treatment group and the corresponding scores in control group(P<0.01).Conclusion:Linggui Bafa acupoint-opening method can alleviate the symptoms of subthreshold anxiety and depression with liver depression transforming into fire syndrome,and the effect is more durable.Linggui Bafa acupoint-opening method coincides with the holistic regulatory advantages of traditional Chinese medicine according to the theories of temporal adaptability and unity of human and nature.The efficacy of Linggui Bafa acupoint-opening method is superior to the conventional acupuncture without opening points.
黄倩怡;陈珺珺;杨兴伟;唐江飞
大理白族自治州中医医院,云南 大理 671000大理白族自治州中医医院,云南 大理 671000大理白族自治州中医医院,云南 大理 671000大理白族自治州中医医院,云南 大理 671000
医药卫生
阈下焦虑抑郁肝郁化火证灵龟八法开穴针刺汉密尔顿抑郁量表汉密尔顿焦虑量表
subthreshold anxiety and depressionliver depression transforming into fire syndromeLinggui Bafa acupoint-opening methodHamilton Depression ScaleHamilton Anxiety Scale
《中医研究》 2026 (4)
63-67,5
云南省科技厅科技计划项目(202101AZ070001-157)
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