补肾解郁清心方结合针刺对围绝经期抑郁症患者ACT-INH-FS通路的影响  

Effect of Bushen-Jieyu-Qingxin decoction combined with acupuncture on ACT-INH-FS pathway of women with perimenopausal depression

作　　者：沈捷雯 董莉[2] 黄宏丽[2] SHEN Jiewen DONG Li HUANG Hongli(Huangpu District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 200010, China Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China)

机构地区：[1]上海市黄浦区中西医结合医院,上海200010 [2]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《现代中西医结合杂志》2017年第23期2512-2514,2524,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：上海市中医药事业发展三年行动计划项目(ZYSNXD-CC-ZDYJ051);国家中医药管理局海派朱氏妇科流派传承工作室(ZY-CCCX-1-1013)

摘　　要：目的探讨补肾解郁清心方结合针刺治疗围绝经期抑郁症患者疗效及对激活素(ACT)-抑制素(INH)-卵泡抑素(FS)(ACT-INH-FS)通路的影响。方法将60例围绝经期抑郁症患者随机分成中药组和针药组各30例,中药组给予补肾解郁清心方口服,针药组给予补肾解郁清心方口服+针刺治疗,2组疗程均为12周。分别在治疗前及治疗12周末对2组患者进行HAMD评分和改良Kupperman量表评分,并检测血清性激素[卵泡刺激素(FSH)、雌二醇(E_2)及黄体生成素(LH)]、ACT、INH、FS水平。结果 2组治疗后HAMD评分、改良Kupperman量表评分均明显降低(P均<0.05),且针药组均明显低于中药组(P均<0.05)。2组治疗后FSH、LH、FS、ACTA水平均明显降低(P均<0.05),针药组治疗后E_2、INHB水平均明显升高(P均<0.05),针药组治疗后FSH、LH、E_2、FS、ACTA、INHB改善情况均明显优于中药组(P均<0.05)。针药组有效率明显高于中药组(P<0.05)。结论补肾解郁清心方单用和补肾解郁清心方联合针刺治疗均能缓解患者围绝经期抑郁症状,降低血清FSH、LH、FS、ACTA水平,但针药联合治疗疗效更好,且能提高血清E_2、INHB水平,对ACT-INH-FS通路影响更明显,可以更好地发挥抗抑郁作用。Objective It is to study the curative effect of Bushen-Jieyu-Qingxin decoction combined with acupuncture on perimenopausal depression, and on ACT-INH-FS pathway in the patients. Methods 60 patients with perimenopausal depression were randomly divided into Chinese medicine group （30 cases） treated with Bushen-Jieyu-Qingxin decoction by oral administration and acupuncture ＋ Chinese medicine group （30 cases） treated with acupuncture ＋ Bushen-Jieyu-Qingxin decoction. Both groups were treated for 12 weeks. HAMD scores, modified Kupperman scores were evaluated, and the levels of serum sex hormone （FSH, LH, E2）, ACT, INH, FS were determined before treatment and after 12 weeks＇ treatment in both groups. Results After treatment, HAMD scores, modified Kupperman scores were significantly decreased in both groups, and the decrease in acupuncture ＋ Chinese medicine group were more significant compared with Chinese medicine group （P 〈 0.05 ） ; the levels of FSH, LH, FS, ACTA in both groups were decreased （ P 〈 0.05） , the levels of E2 , INHB were increased in acupuncture ＋ Chinese medicine group （P 〈 0.05） , the improvements of FSH, LH, E2 , FS, ACTA, INHB were better in acupuncture ＋ Chines medicine group than that in Chinese medicine group （P 〈 0.05 ）. The effective rate in acupuncture ＋ Chines medicine group was higher than that in Chinese medicine group （ P 〈 0.05 ）. Conclusion The treatment with Bushen-Jieyu- Qingxin decoction only or with combination of acupuncture and Bushen-Jieyu-Qingxin decoction both can effectively relieve perimenopausal depression symptoms, and decrease the levels of serum FSH, LH, FS, ACTA, but the curative effect of the combination therapy was better, furthermore, it could improve the levels of serum E2 , INHB, influence iACT-INH-FS pathway more significantly, and play a role of antidepress more effectively.

关 键 词：围绝经期抑郁症 针刺疗法 补肾解郁清心方 ACT-INH-FS通路 

分 类 号：R271.116[医药卫生—中医妇科学]