针刺联合正念认知疗法治疗经前期综合征随机对照研究

目的观察针刺联合正念认知疗法(mindfulness-based cognitive therapy,MBCT)治疗经前期综合征(premenstrual syndrome,PMS)的疗效。方法将130例PMS患者随机分为针刺组43例、MBCT组43例和针刺+MBCT组44例,其中针刺组和针刺+MBCT组各脱落4例,MBCT组脱落3例。针刺组取穴百会、神庭、命门、腰俞、腰阳关、关元、中脘、中极,根据穴位位置取仰卧位和俯卧位,每穴治疗各15 min,每周2次;MBCT组进行正念认知干预,每周1次;针刺+MBCT组在行针刺治疗的同时联合MBCT。3组均以8周为1个疗程,共治疗1个疗程。治疗前后,采用经前期症状评定简表(shortened premenstrual assessment form,SPAF)评定PMS症状改善情况,状态-特质焦虑问卷评定治疗前后状态焦虑(state-anxiety inventory,S-AI)和特质焦虑(trait-anxiety inventory,T-AI)的变化。结果与治疗前比较,3组患者治疗前后SPAF总分和情感因子、水肿因子、疼痛因子以及S-AI和T-AI总分均显著降低(P<0.05);3组SPAF总分和情感因子、水肿因子、疼痛因子、S-AI和T-AI评分治疗前后差值比较,差异均有统计学意义(P<0.05),针刺+MBCT组差值最大。结论针刺联合MBCT较单纯应用针刺和MBCT治疗PMS的效果更佳。

Clinical Effect of Acupuncture Combined with Mindfulness-based Cognitive Therapy in Treatment of Premenstrual Syndrome: A Randomized Controlled Trial

Objective To investigate the clinical effect of acupuncture combined with mindfulness-based cognitive therapy (MBCT) in the treatment of premenstrual syndrome (PMS). Methods A total of 130 patients with PMS were randomly divided into acupuncture group with 43 patients, MBCT group with 43 patients, and acupuncture+MBCT group with 44 patients. Four patients in the acupuncture group, four in the acupuncture+MBCT group, and three in the MBCT group were lost to follow-up. For the patients in the acupuncture group, acupuncture was performed at Baihui, Shenting, Mingmen, Yaoshu, Yaoyangguan, Guanyuan, Zhongwan, and Zhongji points in the supine position and the prone position, with 15 minutes for each acupoint, twice every week; the patients in the MBCT group were given MBCT once a week; the patients in the acupuncture+MBCT group were given acupuncture combined with MBCT. Each course of treatment was 8 weeks, and each group was treated for one course. Shortened Premenstrual Assessment Form (SPAF) was used to evaluate the improvement in the symptoms of PMS, and State-Trait Anxiety Inventory was used to assess the changes in State Anxiety Inventory (S-AI) and Trait Anxiety Inventory (T-AI) scores after treatment. Results After treatment, all three groups had significant reductions in the total score of SPAF and the scores of its affective factors, edema factors, and pain factors as well as the total scores of S-AI and T-AI (P<0.05), and there was a significant difference in the degree of such reductions between the three groups (P<0.05), with the greatest reductions in the acupuncture+MBCT group. Conclusion Acupuncture combined with MBCT has a better clinical effect than acupuncture or MBCT alone in the treatment of PMS.