中医药治疗产后抑郁研究进展  

Research Progress in the Treatment of Postpartum Depression with TCM

作　　者：苏虹 粟胜勇[2] 羊璞 郭彦君 彭柳馨 SU Hong;SU Sheng-yong;YANG Pu;GUO Yan-jun;PENG Liu-xin(Guangxi University of Chinese Medicine,Nanning,Guangxi,China,530001;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning,Guangxi,China,530001)

机构地区：[1]广西中医药大学,广西南宁530001 [2]广西中医药大学第一附属医院,广西南宁530001

出　　处：《河南中医》2022年第10期1605-1609,共5页Henan Traditional Chinese Medicine

基　　金：国家自然科学基金项目(821609934);国家十二五科技支撑计划分课题项目(2012BAI24B01);2018年广西壮族自治区一流学科建设项目重点课题项目(2018XK075)。

摘　　要：中医药治疗产后抑郁多采用经典方剂、自拟方剂、中成药、中药外用及针灸疗法等,可调节下丘脑-垂体-肾上腺轴、下丘脑-垂体-性腺轴,进而改善相关神经递质水平、神经内分泌因子及激素水平,营养兴奋脑神经,显著改善患者焦虑抑郁状态以及躯体症状,降低抑郁量表评分。目前,仍存在以下不足:①初产妇缺乏对分娩过程的了解,易产生紧张、焦虑、恐惧等不良心理反应,既往有不良孕产史的产妇伴随焦虑、抑郁的比例更大;②产后抑郁的中医辨证分型难以统一,多是辨病而治;③产后抑郁发病具有隐匿性、反复性等特征,应当重视不同干预时间的临床疗效及相关指标变化,以期评估最佳治疗周期方案,远期观察及巩固治疗十分有必要。今后,应重视妊娠期身体及情志的护理,运用五音疗法、中医外治、传统功法锻炼等指导孕产妇,达到身心同调、防患于未然的目的。此外,应加强对产后抑郁不同人群、不同证型进行辨证论治的临床研究。TCM is often used to treat postpartum depression,such as classic prescriptions,self-made prescriptions,Chinese patent medicine,external use of TCM and acupuncture therapy,which can adjust the hypothalamus-pituitary-adrenal axis,and hypothala-mus-pituitary-gonadal axis,so as to improve the level of related neurotransmitters,neuroendocrine factors and hormones,nourish and excite the brain nerves,significantly improve the anxiety and depression status and somatic symptoms of patients,and reduce the score of depression scale.At present,there are still the following limitations:①Primiparas lack understanding of the delivery process,which is prone to adverse psychological reactions such as tension,anxiety and fear,and the proportion of pregnant women with a past history of adverse pregnancy and childbirth accompanied by anxiety and depression is larger;②It is difficult to unify the syndrome differentiation and classification of postpartum depression in TCM,which is mostly based on disease differentiation and treatment;③The onset of postpartum depression has the characteristics of concealment and repetition.We should pay atten-tion to the clinical efficacy and changes of relevant indicators at different intervention times in order to evaluate the best treatment cycle plan.Long term observation and consolidation of treatment are very necessary.In the future,it is necessary to pay attention to the physical and emotional care during pregnancy,and use five-tone therapy,external treatment of TCM,traditional exercise and other methods to guide pregnant women,so as to achieve the purpose of physical and mental harmony and prevention.In addition,we should strengthen the clinical research on syndrome differentiation and treatment of postpartum depression in different groups and different syndrome types.

关 键 词：产后抑郁 郁证 中医内治 中医外治 综合疗法 

分 类 号：R277.749.4[医药卫生—中医学]