目的 耳甲电针已被证明类似迷走神经刺激（Vagus Nerve Stimulation，VNS），治疗抑郁症有效，本研究探讨耳甲电针治疗难治性抑郁症（Treatment Resistant Depression，TRD）的临床增效效应。方法 通过门诊及广告招募到23例TRD患者，采用耳迷走神经刺激仪（SDZ-IIB，华佗牌）刺激患者双侧耳甲区进行治疗，每天早晚各1次，每次30 min，共2次，原基础药物治疗保持不变。分别于治疗前及治疗2、4、8周采用汉密尔顿抑郁量表总分（Hamilton Depression Scale,HAMD-17）、抑郁自评量表总分（Self-rating Depression Scale，SDS）、汉密尔顿焦虑量表总分（Hamilton Anxiety Scale，HAMA-14）、焦虑自评量表（Self-rating Anxiety Scale，SAS）、匹兹堡睡眠质量指数量表（Pittsburgh Sleep Quality Index，PSQI）、冗思反应量表（Rumination Response Scale，RRS）等6个临床心理量表评定临床疗效。结果 除脱落3例外，大部分患者治疗2、4、8周后，症状逐渐减轻， HAMD、HAMA、SDS、SAS量表评分减分率均具有统计学意义（P ＜ 0.001），HAMD平均减分率分别为43.77%、61.74%、74.83%，临床痊愈9例（9/20），8例显著进步，2例进步，1例无效，总反应率为95.0%。治疗8周后RRS、PSQI量表评分与治疗前比较，显示差异均有统计学意义（P ＜ 0.005）。结论 耳电针对TRD具有一定的治疗作用。

Objective Auricular electro-acupuncture has been proved to be effective in the treatment of depression, whose clinical efficacy is similar to vagus nerve stimulation (VNS). This study was designed to explore the clinical effect of auricular electro-acupuncture in treatment-resistant depression (TRD).Methods A total of 23 patients with TRD were recruited while the transcutaneous auricular vagus nerve stimulation (taVNS, Huatuo brand, SDZ-IIB) were used to stimulate bilateral ear concha for treatment twice a day (in the morning and evening), each for 30 minutes. The original basic drug treatment remained unchanged. It was observed in six psychological scale scores before treatment (week 0), in the period of treatment (2 weeks ± 3 days, 4 weeks ± 3 days, 8 weeks ± 3 days), including 17-item Hamilton Depression Scale (HAMD-17), 14-item Hamilton Anxiety Scale (HAMA-14), self-Rating Depression Scale (SDS), self-Rating Anxiety Scale (SAS) scores, the Pittsburgh Sleep Quality Index (PSQI) and the Ruminative Response Scale (RRS) scores.Results Except for 3 cases dropping off, the symptoms of most patients were alleviated gradually after 2, 4 and 8 weeks of treatment. The scores of HAMD, HAMA, SDS and SAS were significantly decreased (P < 0.001). The average reduction rate of HAMD scores were 43.77%, 61.74% and 74.83%, respectively. 9 subjects reached clinical recovery, 8 subjects symptoms showed improved significantly, 2 subjects were improved, and 1 subject was ineffective. The response rate was 94.1%. Comparing the RRS/PSQI scores between 0 week and 8 weeks after treatment, and the differences show statistically significant (P < 0.005).Conclusion Auricular electro-acupuncture has an effect on TRD.