浮针治疗抗抑郁药物性便秘疗效观察

Clinical observation of Fu’s subcutaneous needling for antidepressant-induced constipation

关键词:  浮针治疗  抗抑郁药物性便秘  随机对照试验  排便困难  患者满意度

Key words:  Fu’s subcutaneous needling  antidepressant-induced constipation  randomized controlled trial  defecation difficulty  patient satisfaction

摘要:

[目的] 探讨浮针治疗抗抑郁药物性便秘（AIC）的临床疗效、安全性及患者满意度情况。[方法] 采用随机对照试验设计，将符合纳入标准的70例AIC患者，随机分为浮针治疗组和对照组，每组35例。浮针治疗组于第1、2、3、6、9、13天进行浮针治疗，共计6次，对照组给予增加膳食纤维、多饮水、适当运动、养成良好排便习惯等基础治疗，干预周期为2周，4周时进行随访。并以每周完全自主排便次数（CSBM）、排便困难程度为主要观察指标，以大便性状评分、抑郁症筛查量表（PHQ-9）评分、焦虑症筛查量表（GAD-7）评分、患者满意度、安全性与依从性为次要观察指标。采集及记录治疗前、治疗1、2周及第4周随访数据，采用SPSS 17.0软件进行统计学分析。[结果] 治疗前两组数据比较，差异不具有统计学意义（P>0.05），表明组间可比性良好。浮针治疗组在治疗1、2周及第4周随访时CSBM高于对照组（P<0.05），排便困难程度低于对照组（P<0.05），治疗1、2周的PHQ-9、GAD-7评分优于对照组（P<0.05），浮针治疗组患者满意度高于对照组（P<0.05）。两组大便性状评分相当（P>0.05）。浮针治疗组不良反应发生率为3.03%，依从性为80%。对照组依从性为80%。[结论] 浮针疗法可以有效改善AIC患者的排便频次、排便困难及生活质量，安全性高，依从性好，值得临床推广应用。

Abstract:

[Objective] To investigate the clinical efficacy，safety，and patient satisfaction of Fu’s subcutaneous needling（FSN）for antidepressant-induced constipation（AIC）. [Methods] A randomized controlled trial was conducted. Seventy AIC patients meeting the inclusion criteria were randomly divided into an FSN treatment group and a control group，with 35 patients in each group. The FSN treatment group received FSN on days 1，2，3，6，9， and 13（6 sessions in total）. The control group received basic treatments including increased dietary fiber，adequate water intake，appropriate exercise，and good defecation habits. The intervention period was 2 weeks，with a follow-up at 4 weeks. The primary outcome measures were weekly complete spontaneous bowel movements（CSBM）and the degree of defecation difficulty. Secondary outcome measures included stool consistency score，Patient Health Questionnaire-9（PHQ-9），Generalized Anxiety Disorder-7（GAD-7），patient satisfaction，safety，and compliance. Data were collected before treatment，at 1 week and 2 weeks after treatment，and at the 4-week follow-up，and analyzed using SPSS 17.0 software. [Results] No significant differences were found between the two groups before treatment，indicating good comparability. At 1 week，2 weeks，and the 4-week follow-up，the FSN treatment group showed significantly higher CSBM（P<0.05）and significantly lower defecation difficulty（P<0.05）compared with the control group. At 1 and 2 weeks after treatment，the PHQ-9 and GAD-7 scores in the FSN treatment group were significantly better than those in the control group（P<0.05），and patient satisfaction was significantly higher in the FSN treatment group（P<0.05）. Stool consistency scores were comparable between the two groups（P>0.05）. The incidence of adverse reactions in the FSN treatment group was 3.03%，and the compliance rate was 80%；the compliance rate in the control group was also 80%. [Conclusion] Fu’s subcutaneous needling can effectively improve defecation frequency，defecation difficulty，and quality of life in AIC patients，with high safety and good compliance，warranting clinical promotion and application.