目的 探究中医五音疗法结合药物对抑郁症（MDD）负性情绪及心率变异性（HRV）指标的影响。方法 选取2024年7~10月于某部医院治疗的男性MDD患者64例,按照 1：1 的比例随机分成对照组与试验组,每组32例。对照组进行标准抗抑郁药物治疗,使用药物包括SSRI、SNRI及苯二氮?类药物等,1次/d,治疗时间4周。试验组在标准抗抑郁药物治疗基础上进行中医五音疗法,每周5次,每次30~40 min,治疗时间4周。两组分别在治疗前1天、治疗4周后采用汉密尔顿抑郁量表（HAMD）、患者自评量表（PHQ-9）进行评估,并监测心率变异性（HRV）指标。结果 治疗后,两组HAMD评分、PHQ-9评分均优于治疗前,差异有统计学意义（P<0.05）。且试验组的HAMD评分[（6.29±4.13）vs.（9.77±7.31）]及PHQ-9评分[（3.32±2.51）vs.（5.87±5.32）]显著低于对照组,差异具有统计学意义（P<0.05）,试验组HRV时域各项指标优于对照组[SDNN（81.32±31.64）vs.（66.72±28.58）,RMSSD（104.14±68.19）vs.（57.63±34.26）,PNN50（25.48±18.02）vs.（16.64±12.71）],频域指标优于对照组[TP（361.24±201.85）vs.（684.81±404.84）,HF（91.85±111.52）vs.（145.60±125.79）,LF（291.75±129.65）vs.（194.87±90.65）],LF/HF（3.25±2.33）vs.（7.97±6.41）],差异具有统计学意义（P<0.05）。结论 中医五音疗法结合抗抑郁药物可缓解抑郁情绪,改善HRV指标,且安全性较高。
Abstract
Objective To investigate the effects of traditional Chinese medicine's fivetone therapy combined with medication on depressive mood and heart rate variability (HRV) indicators in patients with major depressive disorder (MDD). Methods A total of 64 male MDD patients treated at a military hospital between July and October 2024 were were selected and randomly divided into a control group (n=32) and an experimental group (n=32) at a ratio of 1:1. The control group received standard antidepressant pharmacotherapy, including SSRIs, SNRIs, and benzodiazepine drugs, once a day for 4 weeks, while the experimental group received traditional Chinese medicine's fivetone therapy in addition to the standard pharmacotherapy (30-40 min /session,5 sessions/week for 4 weeks). Both groups were assessed using the Hamilton Depression Rating Scale (HAMD) and Patient After treatment, the HAMD scores and PHQ9 scores of both groups were better than those before treatment, with statistically significant differences (P<0.05).The experimental group demonstrated significantly lower HAMD scores (6.29 ± 4.13 vs. 9.77 ± 7.31; P<0.05) and PHQ9 scores (3.32 ± 2.51 vs. 5.87 ± 5.32; P<0.05) compared to the control group , with statistically significant differences (P<0.05). The timedomain indicators of HRV in the experimental group were better than those of the control group [SDNN (81.32 ± 31.64 vs. 66.72 ± 28.58), RMSSD (104.14 ± 68.19 vs. 57.63 ± 34.26), PNN50 (25.48 ± 18.02 vs. 16.64 ± 12.7）], and the frequencydomain indicators were also better than those of the control group [TP (361.24 ± 201.85 vs. 684.81 ± 404.84), HF (91.85± 111.52 vs. 145.60 ± 125.79), LF (291.75 ± 129.65 vs. 194.87 ± 90.65), LF/HF ratio (3.25 ± 2.33 vs.7.97 ± 6.41）], with statistically significant differences (P<0.05). Conclusions Traditional Chinese medicine's fivetone therapy combined with antidepressant pharmacotherapy can effectively alleviates depressive mood and improve HRV indicators, and it is relatively safe.
关键词
中医五音疗法 /
抑郁症 /
心率变异性 /
药物治疗 /
汉密尔顿抑郁量表
Key words
traditional Chinese medicine's fivetone therapy /
depression /
heart rate variability /
antidepressant pharmacotherapy /
Hamilton Depression Rating Scale
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