| Background:Now mental diseases have play an important role in threatening the health of human being. Depression, one of the most common mental illnesses, have been increasing concerned for its high incidence, serious condition and severe social harm. Making matters worse, scholars have found that another mental disease is easily associated with depression and the state will become heavier and more chronic with the number of accompanying syptoms getting larger. And that will bring great difficulties for the clinical diagnosis, treatment and prognosis. Up to now, the research es about the depression associated with anxiety symptoms are more than others. Comparing with the simple depression or anxiety, the depression associated with anxiety symptoms is more serious, more chronic, more recurrent, more complication, more expensive, more severe social harm, higher disability rates and higher suicide rates. So we must pay more attention.Selective serotonin reuptake inhibitors (SSRIs) is one of the most currently used antidepressants. Seroxat which has the most strongest effect on reuptaking serotonin specially fits for the patient who suffer from the depression and the anxiety at one time and is accepted and widely used by clinicians. But the adverse drug reaction cannot be neglected. Scholars has tried their best to find the other treatment which can promote the effect or reduce the side effects of the antidepresants. Acupuncture, an important part of Traditional Chinese Medicine, is a good antidepressant and antianxiety used in clinic. More and more researches indicated that the patients’ clinical symptoms were improved more obviously when they were extraly treated by acupuncture or electroacupuncture which is well effective, safety and tolerated.Therefore we design a clinical test to observe the change of the effect, the symptoms of depression and anxiety and the quality of life about people who is treated randomly by only seroxat, or combined with acupuncture or electroacupuncture.Objective:To compare the differences of the effect, the symptoms of depression and anxiety, the quality of life and the side effects among people who is treated randomly by only seroxat, or combined with acupuncture or electroacupuncture by some tables, including Clinical Global Impression (CGI), Hamilton Depression Scale (HAMD), Hamilton Axiety Scale (HAMA), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Rating Scale for Side Effects (SERS) and the World Health Organization Quality of Life-BREF (WHOQOL-BREF).Methods:102cases of the depression associated with anxiety patients gathering strictly according to the inclusion criteria and the exclusion criteria were randomly divided into3groups which was named drug group, acupuncture group and electroacupuncture group,34cases in each one. In the drug group, seroxat was prescribed for oral administration, once per day. In the acupuncture group, seroxat was applied in combination with the acupuncture therapy, in which Baihui (GV20) and Yintang (EX-HN3) were taken as the main acupoints. In the electroacupuncture group, seroxat was applied in combination with the electroacupuncture therapy, in which, on the basic therapeutic program as the acupuncture group, the electric stimulation was attached to Baihui (GV20) and Yintang (EX-HN3). Acupuncture was applied once every two days, the treatment of6weeks made one session and one session treatment was required in the research. Before and after the treatment of2,4,6weeks, the CGI, HAMD, HAMA, SDS, SAS, SERS and WHOQOL-BREF were adopted for the assessment in each group. After another4weeks, there was a follow-up and the patients were assessed with HAMD, HAMA, SDS and SAS again. All data analyses were performed using Statistical Package for the Social Science (SPSS)13.0.Results:1. Baseline index comparison:There were no significant differences from the gender composition, aging and course of disease among the three groups (P>0.05), so other indexes of the three groups could be compared.2. CGI comparison:The severity of illness (SI) after6weeks’treatment was all alleviated significantly for the patients in three groups as compared with that before treatment (P<0.001), but the difference was not significant statistically among three groups (P>0.05). The global improvement (GI) was different significantly among three groups (P<0.05), in which GI in the electroacupuncture group was the best, that in the acupuncture group was taken second place. The total improvement rates were100.0%(29/29),96.9%(31/32) and93.5%(29/31) separately, but there was no significant difference among the groups (P>0.05). The distinct improvement rates were69.0%(20/29),62.5%(20/32),38.7%(12/32) separately, where presented significant statistically (P<0.05). The difference in the efficacy index (El) was not significant statistically among three groups (P>0.05). 3. HAMD comparison:With the treatment time going on, the total score and the five factors scores (psychic anxiety, mood, somatic anxiety, cognitive disturbance and sleep disturbance) of HAMD becomed lower and lower. What’s more, the total score was less than17point after4weeks’treatment. After the treatment of2,4,6and10weeks, the three groups’all HAMD scores were significantly decreased versus before treatment (P<0.05). At the same treatment time, the total score and the factor scores of psychic anxiety and mood in the acupuncture group and the electroacupuncture group were all less than than in the drug group, in which, the total score and the factor scores of mood and somatic anxiety presented significant statistically after2weeks’treatment (P<0.05) and aftet6weeks the psychic anxiety factor score also presented significant statistically between the acupuncture group and the drug group (P<0.05).4. HAMA comparison:With the treatment time going on, the total score and the two factors scores (psychic anxiety and somatic anxiety) of HAMA becomed lower and lower. What’s more, the total score which was less than14point after4weeks’treatment was less than14point after6weeks’treatment in the acupuncture group and the drug group. After the treatment of2,4,6and10weeks, the three groups’all HAMA scores were significantly decreased versus before treatment (P<0.05). But there were no significant differences at the same treatment time among the three groups (P>0.05).5. SDS comparison:With the treatment time going on, the SDS score becomed lower and lower. After the treatment of2,4,6and10weeks, the three groups’SDS score was significantly decreased versus before treatment (P<0.05). At the same treatment time, there was only the score after2weeks’treatment in the acupuncture group and the electroacupuncture group significantly lower than that in the drug group (P<0.05). 6. SAS comparison:With the treatment time going on, the SAS score becomed lower and lower. After the treatment of2,4,6and10weeks, the three groups’SAS score was significantly decreased versus before treatment (P<0.05). But there were no significant differences at the same treatment time among the three groups (P>0.05).7. SERS comparison:With the treatment time going on, the SERS score becomed lower and lower. After the treatment of2,4and6weeks, the three groups’SERS score was significantly decreased versus before treatment (P<0.05). But there were no significant differences at the same treatment time among the three groups (P>0.05).8. WHOQOL-BREF comparison:Compared with those before treatment, all the indices in the electroacupuncture group were increased significantly after6weeks’treatment (P<0.05). Except the indices in the physiological field, all the other indices were improved in the acupuncture group after6weeks’treatment (P <0.05). The scores only in the physiological field and social field were higher significantly than those before treatment in the drug group (P<0.05). After6weeks’treatment, the statistically significant differencee was displayed only in the psychological field among three groups (P<0.05), in which the improvement in the electroacupuncture group was the best, that in the acupuncture group was taken second place and that in the drug group was the worst.Conclusions:1. Only using seroxat or combining with the seroxat and the treatment by acupuncture/electroacupuncture can reduce the severity of illness, enhance the effect, improve the symptoms and the quality of life and ease the side effects.2. We can see that, the combining treatment was better than the only seroxat one, in which, the total improvement rates and the distinct improvement rates were higher, the depression symptoms and the quality of life of the physiological field were better, but there was no significant improvement about the anxiety symptoms and the other field of the quality of life.3. What’s more, combining electroacupuncture presents better than the acupuncture about the total effect and the physiological field of the quality of life.4. During the follow-up, we found that every group have kept good effect of anti-depression and anti-anxiety, but there was no score presented significant differences among the three group. |
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