针刺联合药物治疗心脏神经官能症的疗效观察

目的 探讨针刺联合药物治疗心脏神经官能症（cardiac neurosis，CN）的临床疗效。方法 选取本院门诊就诊的90例CN患者，随机分为单纯针刺组、单纯药物组、针刺+药物组，每组各30例。单纯针刺组取百会、神庭、内关、神门、心俞、大陵常规针刺为主，单纯药物组给予规律口服西药酒石酸美托洛尔、谷维素片、氟哌噻吨美利曲辛片，针刺+药物组为上述针刺疗法结合西药治疗，共治疗8周。于治疗前、治疗4周和8周后观察3组的汉密顿抑郁量表（HAMD）评分和汉密顿焦虑量表（HAMA）评分，比较治疗后3组患者的临床疗效。结果 治疗4周、8周后，3组患者HAMD、HAMA评分均较治疗前有所降低（P<0.05，P<0.01）；单纯针刺组和单纯药物组患者在治疗4周后和8周后的HAMD、HAMA评分均高于针刺+药物组，差异有统计学意义（P<0.05）。单纯针刺组和单纯药物组总有效率均低于针刺+药物组，差异比较有统计学意义（P<0.05，P<0.01）。结论 单纯针刺和西药治疗CN有一定的效果，两者合用后治疗效果得到较大的提高，可将药物治疗和针刺疗法有机的结合广泛应用于临床。

Effect of Acupuncture Combined with Drug on Cardiac Neurosis

Objective To evaluate the effect of acupuncture combined with drugs in the treatment of cardiac neurosis (CN). Methods 90 cases of CN patients in our hospital were randomly divided into simple acupuncture group, simple drug group, acupuncture+drug group, 30 cases in each group. Acupuncture of Baihui, Shenting, Neiguan, Shenmen, Xinshu, Daling conventional acupuncture, simple drug group received oral medicine of metoprolol tartrate, oryzanol tablets, flupentixol and melitracen tablets, and the acupuncture medicine group acupuncture combined with western medicine treatment, a total of 8 weeks of treatment. Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) in 3 groups before treatment, after treatment for 4 weeks and 8 weeks were evaluated. Results After treatment for 4 weeks, 8 weeks, HAMD and HAMA scores of patients in 3 groups were lower than before treatment (P<0.05, P<0.01). After treatment for 4 weeks and 8 weeks, HAMD and HAMA scores in simple acupuncture group and simple drug group were higher than the acupuncture plus drug group, the difference was statistically significant (P<0.05). The total effective rate of the single acupuncture group and the single drug group was lower than that of the acupuncture plus drug group, the difference was statistically significant (P<0.05, P<0.01). Conclusion Simple acupuncture and Western medicine show some certain effect in treatment of CN. After the combination of the two methods, the treatment effect has been greatly improved, and the combination of drug therapy and acupuncture therapy can be applied widely in clinic.