中西医治疗围绝经期抑郁症的临床研究进展  

Clinical Research Progress of Perimenopausal Depression by Traditional Chinese Medicine and Western Medicine

作　　者：王妍文[1] 符文彬[2] 

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广东省中医院针灸科,广东广州510120

出　　处：《辽宁中医杂志》2011年第8期1683-1687,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(30772828);广东省科技厅科技计划项目(2008B030301206)

摘　　要：目的:对治疗围绝经期抑郁症的各种中西医方法做一总结,旨在中西合璧,发挥各自优势,共同提高临床疗效。方法:应用计算机检索中国期刊全文数据库、中文科技期刊数据库、万方中华医学会期刊数据库,以"围绝经期抑郁症+更年期抑郁症+更年期忧郁症"为首次检索词,以不同治疗方法为二次检索词,检索年限:1999年1月—2010年12月。电子检索后经人工筛查,排除科普文献、文献综述、各数据库重复录入的文献。结果:最终搜集到162篇文献,阅读全文,选取较高质量文献对其做一总结。结论:①中医治疗围绝经期抑郁症的方法有中药、针刺、艾灸、推拿、走罐等,目前,对于中药治疗本病的研究起步早,研究多,而针灸方面较少,仅有18篇文献。②西医治疗本病主要使用雌激素和抗抑郁药,临床多联合用药。③心理、运动干预所起的具体作用及成效,还缺乏数据论证。单因素干预因受到伦理学影响,很难进行随机对照研究。④研究的诊断标准过于单一,缺少针对"围绝经期抑郁症"的专有标准;疗效标准除了参照HAMD评分或减分率,还应关注患者血液激素水平,症状改善及生活质量。⑤缺少长期疗效及复发率的统计,各种干预措施的远期疗效不确定,有待进一步完善。总之,中西医综合疗法治疗围绝经期抑郁症疗效显著,副作用小,临床应积极推广,但研究设计还有待优化。Objective：Make a summary of Chinese and Western treatments in perimenopausal depression, a good combination can very well display their respective advantages and improve the clinical efficacy. Methods ： The relative articles were searched in CNKI,VIP and CMAJ electronic database published from 1989 to 2010, the first keywords is ＂Perimenopausal depression＂ , and the second one is different treatments. After searching by computer and checking by men, science works, literature review, reduplicate literature of all databases was removed. Results ： Ultimately, 162 documents was collected, we read the full text and select high quality literature to do a summary. Conclusion：（1）The treatments of perimenopausal depression are traditional Chinese drug, acupuncture moxibustion, massage, and mobiling cupping jar etc. At present,the study on traditional Chinese drug is not only the origin of early but more, while acupuncture, only 18 references. （2）Western medicine therapy mainly use this estrogen and antidepressants, and more combination. （3）The specific role and effectiveness of psychological and exercise intervention are also lack of evidence. Ethics influence in Single factor intervention make it hard for RCT. （4） Standard of Diagnosis is too easy,lack of proprietary standards for perimenopausal depression. Besides HAMD,we also should make a focus on hormone levels,improvement of symptoms and quality of life. （5） Long - term efficacy of intervention measures is uncertain because of less statistics in it and relapse rate, and there is nmch to be improved in the future, so, Combined therapy for Perimenopausal depression is effective and less neg- ative effects. Enthusiast Promotion is necessary in clinical research, but the research design remains to be optimized.

关 键 词：围绝经期抑郁症 中西医:治疗 综述 

分 类 号：R271.116[医药卫生—中医妇科学]