| Objective: This study is based on the heart-brain theory,by observing the treatment of generalized anxiety disorder(GAD)patients with paroxetine alone,and on the basis of paroxetine,acupuncture with simple heart-centering and simultaneous treatment of heart and brain.Stimulate the difference in the efficacy of three different treatment methods,and explore the effectiveness and superiority of GAD from the heart and brain.Methods: The 114 subjects who accord with the inclusion criteria were randomly divided into group A(38 cases),group B(38 cases),and group C(38 cases)according to the random number table,of which group A and B were the control groups,group C for the treatment group.The initial dose of paroxetine in the group A was 20 mg,which could be gradually increased according to the condition,and it was increased by 10 mg every week,the maximum dose was 50mg/d,and it was taken daily at breakfast;Both groups B and C were treated with acupuncture based on the treatment of group A,while group B was mainly focused on regulating heart: Taichong(bilateral),Sanyinjiao(bilateral),Neiguan(bilateral),Shenmen(bilateral)and Xinshu(bilateral).In group C,acupuncture points are selected by simultaneously regulating heart and brain: Taichong(bilateral),Sanyinjiao(bilateral),Baihui,Yintang,Sishencong(point selection before and after or left and right alternately),Shenting,Neiguan(bilateral),Shenmen(bilateral),Xinshu(bilateral);All points are penetrated into the corresponding depth,it is appropriate to get qi.Both groups retained needles for 30 minutes at a time,without needles during the needle retention period,once a day,4 times a week,two weeks as a course of treatment,a total of 3 courses of treatment,that is 6 weeks.The three groups were evaluated HAMA,SAS and TESS before treatment,after the end of the second,fourth,and sixth weeks of treatment;SDSS assessments were performed before treatment,at the end of the 6th week of treatment,and at 1 month follow-up after the end of the total course of treatment.Use SPSS20.0 software to conduct statistical analysis on the obtained data.Results:1.Total efficiency comparisonAfter the first course of treatment: The effective rate in group A was 59.38%,that in group B was 66.67%,and that in group C was 69.70%.There was no significant difference in the three groups' effective rates by multi-sample rank sum test of grade data(P > 0.05).After the second course of treatment: The effective rate in group A was 68.75%,that in group B was 84.85%,and that in group C was 84.85%,and the effective rate of the three groups was statistically different by rank data multi-sample rank sum test(P < 0.05);Pairwise comparison: P = 0.192 in the AB groups and the difference was not significant(P > 0.05);P = 0.010 in the AC groups sand the difference was significant(P < 0.05);P = 0.808 in the BC groups and the difference was not significant(P > 0.05).After the third course of treatment: The effective rate in group A was 71.88%,in group B was 78.79%,in group C was 87.88%,and the effective rate of the three groups was statistically different by the rank sample multi-sample rank sum test(P < 0.05);Pairwise comparison: P = 0.552 in the AB groups was not significantly different(P > 0.05);P = 0.004 in the AC groups was significantly different(P < 0.05);P= 0.165 in the BC groups was not significantly different(P > 0.05).2.Intra group score comparisonThe HAMA,SAS scores of three groups in each treatment course were lower than that before treatment(P < 0.05);The SDSS scores of the three groups decreased at the end of the treatment course and at the follow-up(P < 0.05);3.Comparison of scores between groupsHAMA: There was no significant difference in scores between the three groups after the first and second courses(P > 0.05);after the third course of treatment,the HAMA score of group C was lower than that of group A,that is,the efficacy of group C was better than group A(P < 0.05).SAS: There was no significant statistical difference between the three groups after the end of the first course of treatment(P > 0.05);the effect of group C was better than that of groups A and B at the end of the second course of treatment(P < 0.05);the end of the third course of treatment was C The group is better than the group A(P < 0.05),and there is no significant difference between the scores of the two groups B and C(P > 0.05).SDSS: There was no significant statistical difference between the three groups after follow-up after the third course of treatment and one month after the end of the total course of treatment(P > 0.05).4.Safety evaluationTESS: The scores of group C were significantly lower than those of group A after the first and second courses(P < 0.05),and there was no statistically significant difference between the three groups after the end of the third course(P > 0.05);The side reactions that occur are mild,and the symptoms can be reduced or disappeared with the time of medication by strengthening observation or reducing the dose of the drug.During the treatment period,11 people in groups B and C had acupuncture adverse events,and 5 patients had hematoma at the acupuncture site;2 patients felt palpitations and palpitation during treatment;3 patients had pain and local numbness at the acupuncture site;blood pressure increased slightly One person was the highest;the above adverse reactions were not treated specially,and the symptoms disappeared after the patient rested or observed for a period of time.Conclusions:1.HAMA and SAS scores showed that: in improving GAD symptoms,paroxetine combined with heart-brain acupuncture is better than oral paroxetine alone,and it has a faster effect than paroxetine combined with heart acupuncture;2.SDSS score showed that paroxetine,paroxetine combined with heart acupuncture,paroxetine combined with heart-brain acupuncture can improve the social function of GAD patients,and there is no significant difference in the long-term effect of improving social function.3.The TESS score showed that paroxetine combined with heart-brain acupuncture can antagonize the side effects of paroxetine in the treatment of GAD. |
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