微砭耳针治疗冠心病经皮冠状动脉介入术后伴抑郁患者的临床观察

王尔玉 张健真 张楠楠 孔令旗 修晟尧 李天力 常佩芬

〔摘要〕 目的 觀察微砭耳针对冠心病经皮冠状动脉介入术（percutaneous coronary intervention， PCI）后并抑郁状态患者的抑郁情绪、睡眠质量以及中医症状的影响。方法 收集2019年3月至2019年12月北京中医药大学东直门医院门诊及病房中冠心病PCI术后并抑郁状态的患者71例，将其随机分为两组（耳针组33例、对照组34例）。对照组规律服用冠心病二级预防药物，予健康教育及简单心理疏导;耳针组在对照组的基础上加用微砭耳针治疗，疗程为4周。观察两组患者有效率及治疗前后汉密尔顿抑郁量表（Hamilton depression scale， HAMD）评分、匹兹堡睡眠质量指数（Pittsburgh sleep quality index， PSQI）评分、中医证候积分的变化情况。结果 治疗后，耳针组有效率87.88%，对照组有效率61.76%，两组比较差异有统计学意义（P<0.01）;治疗后，两组HAMD评分、PSQI评分、中医证候积分均较治疗前改善（P<0.01），且治疗后耳针组各项评分均优于对照组（P<0.01）。结论 微砭耳针可以有效改善冠心病PCI术后并抑郁状态患者的抑郁情绪、睡眠质量及中医症状。

〔关键词〕 微砭耳针;冠心病;经皮冠状动脉介入术;抑郁状态;双心医学;汉密尔顿抑郁量表;匹兹堡睡眠质量指数;中医证候积分

〔中图分类号〕R246       〔文献标志码〕B        〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.12.013

Clinical Observation of Auriculotherapy with Miniature Bian Stone on Patients with

Depression Symptoms After Percutaneous Coronary Intervention

WANG Eryu， ZHANG Jianzhen， ZHANG Nannan， KONG Lingqi， XIU Shengyao， LI Tianli， CHANG Peifen*

（Dongzhimen Hospital， Beijing University of Chinese Medicine， Beijing 100700， China）

〔Abstract〕 Objective To observe the effect of auriculotherapy with miniature Bian stone on the depressive emotions， quality of sleep and TCM syndrome integral of patients with depression symptoms after percutaneous coronary intervention （PCI）. Methods  A total of 71 post-PCI patients with depression symptoms in the outpatient and ward of Dongzhimen Hospital of Beijing University of Chinese Medicine from March 2019 to December 2019 were chosen and randomly divided into two groups （auriculotherapy group： 33 cases， control group： 34 cases）. The control group was given conventional coronary heart disease secondary preventive medications，

health education and basic psychotherapy. The auriculotherapy group was treated with auriculotherapy with miniature Bian stone on the basis of the control group. Both group endured 4 weeks for treatment. The effective rates of two groups， changes of Hamilton depression scale （HAMD） score， Pittsburgh sleep quality index （PSQI） score， and TCM syndrome integral before and after treatment in the two groups were observed. Results Effective rates of the auriculotherapy group and the control group were 87.88% and 61.76% after treatment respectively， the differences between the two groups were statistically significant （P<0.01）; the score of HAMD， the score of PSQI and TCM syndrome integral after treatment were all improved as compared with those before treatment respectively in both the auriculotherapy group and the control group （P<0.01）. The auriculotherapy group demonstrated better outcome on the scores of HAMD， PSQI， TCM syndrome integral than the control group （P<0.01）. Conclusion Auriculotherapy with miniature Bian stone is efficient in improving the emotions， sleep quality and TCM symptoms of post-PCI patients with depression symptoms.

〔Keywords〕 auriculotherapy with miniature Bian stone; coronary heart disease; percutaneous coronary intervention; depression; bicardiac medicine; Hamilton depression scale; Pittsburgh sleep quality index; TCM syndrome score

随着经济的快速发展与物质生活日渐丰富，冠状动脉粥样硬化性心脏病在我国的发生率逐年上升，严重威胁到国民健康[1]。经皮冠状动脉介入治疗（percutaneous coronary intervention， PCI）常用于冠心病病变血管的血运重建，是目前广泛使用的一种治疗手段[2]，通过扩张狭窄的冠状动脉，来改善心肌缺血缺氧状态。……