摘要??目的 探讨揿针干预对乳腺癌术后患者HPA轴功能相关负性情绪的中期调节效果。?方法 采用多中心随机双盲对照试验设计，纳入41例乳腺癌术后伴轻中度负性情绪患者（HADS评分1-14分），随机分为揿针组（n=18）与安慰针组（n=23）。干预组采用背俞穴揿针留置，对照组使用无针尖安慰揿针留置，每周更换2次，持续3周。主要结局指标为医院焦虑抑郁量表（HADS）评分，次要指标包括生活质量量表（EORTC QLQ-C30）及匹兹堡睡眠质量指数（PSQI），于基线、干预3周及随访5周评估。?结果 干预3周后，揿针组HADS总分较基线显著下降（Δ=-4.2±1.1 vs -1.3±0.8, P<0.001），生活质量总分提高（15.6±3.4 vs 6.2±2.1, P=0.013），但PSQI评分组间无差异（P=0.32）。疗效维持至随访5周（P<0.05）。结论 揿针可能通过HPA轴调节改善情绪和生活质量，但对睡眠质量的影响需进一步验证。

ABSTRACT Objective To investigate the mid-term regulation effect of needle intervention on the function-related negative emotions of the HPA axis in patients after breast cancer surgery.??Methods A multicenter randomized double-blind controlled trial was designed to include 41 patients with mild to moderate negative mood (HADS score 1-14 points) after breast cancer surgery, and were randomly divided into needle group (n=18) and placebo group (n=23). The intervention group was placed with needles at the back Yu point, and the control group was replaced twice a week for 3 weeks. The primary outcome was the Hospital Anxiety and Depression Scale (HADS) score, and the secondary measures included the Quality of Life Scale (EORTC QLQ-C30) and the Pittsburgh Sleep Quality Index (PSQI), which were assessed at baseline, 3 weeks of intervention and 5 weeks of follow-up.?Results After 3 weeks of intervention, the total HADS score of the needle picking group decreased significantly compared with baseline (Δ=-4.2±1.1 vs -1.3±0.8, P<0.001), and the total score of quality of life increased (15.6±3.4 vs 6.2±2.1, P=0.013), but there was no difference in PSQI score between groups (P=0.32). The efficacy was maintained until 5 weeks of follow-up (P<0.05). Conclusion Acupuncture may improve mood and quality of life through HPA axis regulation, but the effect on sleep quality needs to be further verified.

中国中医科学院西苑医院济宁医院创新计划项目：基于HPA轴功能调节揿针干预乳腺癌术后肿瘤相关抑郁状态机制及疗效，课题编号：202402，课题负责人：廖娟