针药结合干预围绝经期抑郁患者的临床疗效  

Clinical Effect of Acupuncture Combined with Medicine Intervention on Perimenopausal Depression Patients

作　　者：张晓丹[1] 杨慰[1] 蔡艳[1] 曹凤[1] ZHANG Xiaodan;YANG Wei;CAI Yan;CAO Feng(Department of Traditional Medicine,Seventh People′s Hospital of Shanghai University of Trational Chinese Medicine,Shanghai 200137,China)

机构地区：[1]上海中医药大学附属第七人民医院传统医学科,上海200137

出　　处：《医学综述》2020年第14期2900-2904,共5页Medical Recapitulate

基　　金：上海市浦东新区科技发展基金(PKJ2016-Y18);上海市浦东新区卫生和计划生育委员会学科带头人培养计划(PWRD2018-17)。

摘　　要：目的探讨针药结合干预围绝经期抑郁患者的临床疗效。方法回顾性分析2017年3月至2018年4月上海市第七人民医院传统医学科收治的120例围绝经期伴初发轻、中度抑郁患者的临床资料,根据治疗方法不同分为药物治疗组和针药结合组,各60例。其中,药物治疗组给予疏肝解郁胶囊和莉芙敏片治疗,针药结合组给予宁神方联合电针治疗。治疗12周后,比较两组患者的临床疗效,治疗前后的血清性激素[雌二醇(E 2)、卵泡刺激素(FSH)、黄体生成素(LH)、孕酮(P)]水平、神经递质[去甲肾上腺素(NE)、5-羟色胺(5-HT)、多巴胺(DA)、γ-氨基丁酸(GABA)]水平、汉密顿抑郁量表17项(HAMD-17)评分。结果针药结合组的总有效率高于药物治疗组[90.00%(54/60)比75.00%(45/60)](P<0.05)。治疗前后血清性激素指标(E 2、FSH、LH、P)、神经递质指标(NE、5-HT、DA、GABA)、HAMD-17评分的主效应差异有统计学意义(P<0.05),两组间血清性激素指标、神经递质指标、HAMD-17评分的主效应差异有统计学意义(P<0.05),各指标组间和时点间无交互作用(P>0.05)。结论针药结合能够明显升高围绝经期抑郁患者的性激素水平、神经递质水平,改善抑郁症状。Objective To explore the clinical effect of acupuncture combined with medicine intervention on perimenopausal depression patients.Methods The clinical data of 120 perimenopausal patients with initial moderate depression admitted to Department of Traditional Medicine in Shanghai Seventh People′s Hospital from Mar.2017 to Apr.2018 were retrospectively analyzed.According to the treatment method,the patients were divided into a medication group and an acupuncture and medication combination group,60 cases each.The medication group was given Shugan Jieyu capsule and remifemin tablet.Acupuncture and medication combination group was given Ningshenfang combined with electroacupuncture treatment.After 12 weeks of treatment,the clinical effects,the levels of serum sex hormones[estradiol(E 2),follicle stimulating hormone(FSH),luteinizing hormone(LH),progesterone(P)],the levels of neurotransmitters[noradrenaline(NE),5-hydroxytryptamine(5-HT),dopamine agonist(DA),γ-aminobutyric acid(GABA)]and the scores of 17 items of Hamilton depression scale-17(HAMD-17)of the two groups before and after treatment were evaluated and compared.Results The therapeutic effect of the acupuncture and medication combination group was better than that of the medication group[90.00%(54/60)vs 75.00%(45/60)](P<0.05).There were statistically significant differences in the main effect of serum sex hormone indexes(E 2,FSH,LH,P),neurotransmitter indexes(NE,5-HT,DA,GABA)and HAMD-17 scores before and after treatment(P<0.05);the main effects of serum sex hormone indexes,neurotransmitter indexes and HAMD-17 scores between the two groups were statistically significantly different(P<0.05),and there was no interaction in each index between group and time point(P>0.05).Conclusion The combination of acupuncture and medication can effectively regulate the sex hormone level and neurotransmitter level,and improve depressive symptoms of patients with perimenopausal depression.

关 键 词：抑郁 围绝经期 性激素 神经递质 中药 电针 

分 类 号：R749.42[医药卫生—神经病学与精神病学]