目的 基于双重差分模型(difference-in-differences model,DID)分析耳穴压豆疗法对慢性疼痛伴抑郁患者疼痛和抑郁症状的动态改善作用,为制订个体化干预疗程提供依据。方法 2023年3月至2024年3月,便利抽样法选取在某院治疗的103例慢性疼痛伴抑郁患者为对照组,采用标准化常规护理指导;2024年4月至2025年4月,同法选择同类患者103例为观察组,采用耳穴压豆疗法。干预期为连续4周。采用DID模型,对比两组患者干预前、干预1周、2周、3周、4周后的疼痛视觉模拟评分法(visual analogue scale,VAS)得分、汉密顿抑郁量表(Hamilton depression scale,HAMD)得分,干预前和干预4周后的家庭支持度和观察组患者的安全性指标。结果 两组患者VAS评分和HAMD评分在时间、组别以及交互效应上差异均有统计学意义(均P<0.05)。DID回归模型显示,与对照组相比,观察组随干预时间延长,VAS得分降0.589分,HAMD得分降低2.985分。干预4周后,观察组家庭支持量表得分高于对照组,差异有统计学意义(t=6.934,P<0.05)。观察组共出现耳部皮肤不良反应6例,经对症支持处理后,症状均在3 d内缓解。结论 耳穴压豆疗法用于慢性疼痛伴抑郁患者,可以持续稳定的改善患者的疼痛和抑郁症状,值得推广。

Objective To analyze the dynamic effects of auricular acupressure on pain and depressive symptoms in patients with chronic pain with comorbid depression based on a difference-in-differences(DID) model,so as to provide evidence for formulating individualized intervention regimens.Methods From March 2023 to March 2024,103 patients with chronic pain and depression treated at a hospital were selected by convenience sampling as the control group and received standardized routine nursing guidance.From April 2024 to April 2025,103 similar patients were selected by the same method as the observation group and received auricular acupressure.The intervention lasted for four consecutive weeks.The DID model was used to compare the Visual Analogue Scale(VAS) and Hamilton Depression Scale(HAMD) scores of the two groups before the intervention and at weeks 1,2,3,and 4 after the intervention,as well as family support before the intervention and at week 4 after the intervention,and the safety indicators of the observation group.Results The VAS and HAMD scores of the two groups showed statistically significant differences in time effect,group effect,and interaction effect(all P<0.05).The DID regression model showed that,compared with the control group,the VAS score of the observation group decreased by an additional 0.589 points and the HAMD score decreased by an additional 2.985 points as the intervention time prolonged.After four weeks of intervention,the family support scale score of the observation group was higher than that of the control group,and the difference was statistically significant (t=6.934,P<0.05).A total of six cases of ear skin adverse reactions occurred in the observation group,and all symptoms were relieved within three days after symptomatic supportive treatment.Conclusions Auricular acupressure can continuously and steadily improve pain and depressive symptoms in patients with chronic pain with comorbid depression,and is worthy of promotion.

R47;R473.3;R823

大同市重点研发计划项目(2023018)