产后抑郁症针灸诊疗特点文献分析  

Literature Analysis on the Characteristics of Acupuncture Diagnosis and Treatment for Postpartum Depression

作　　者：徐玉芹 赵宏[1,2] 丰逸轩 范琦 崔硕 XU Yuqin;ZHAO Hong;FENG Yixuan;FAN Qi;CUI Shuo(Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences,Beijing 100007,China;Shenzhen Luohu District Hospital of Traditional Chinese Medicine,Shenzhen 518004,China)

机构地区：[1]中国中医科学院针灸研究所,北京100007 [2]深圳市罗湖区中医院,广东深圳518004

出　　处：《西部中医药》2024年第3期39-43,共5页Western Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划(中医药现代化研究项目)(2017YFC1703606)。

摘　　要：目的:探讨针灸治疗产后抑郁症(postpartum depression,PPD)的诊疗特点和规律。方法:检索中国知网(1999—2020年)、维普(1999—2020年)、万方数据知识服务平台(1999—2020年)、PubMed(1999—2020年)、Google Scholar(1999—2020年)数据库中针灸治疗PPD的文献,分析总结常用诊断标准、疾病程度分级、针灸干预措施、辨证及选穴特点、治疗频次、总疗程、近期疗效、随访及安全性。结果:共纳入37篇文献,其中诊断标准使用美国精神病学会1994年出版的《精神疾病的诊断与统计手册(DSM-IV)》占45.95%(17/37),《中国精神障碍分类与诊断标准》第三版(CCMD-3)占32.43%(12/37);纳入患者抑郁程度分级不明确占72.97%(27/37);治疗最常采用针灸联合心理治疗占24.32%(9/37),其次为针灸联合中药治疗占21.62%(8/37);多采用标准化方案占75.68%(28/37);最常见证型为肝郁型占13.51%(5/37);11个常用穴位依次为百会穴、太冲、足三里、内关、三阴交、神门、期门、四神聪、心俞、脾俞、关元;针灸治疗频次多为每日1次占45.95%(17/37);总疗程为6周占45.95%(17/37);有效率为76.9%~97.6%;随访率不高,仅占5.41%(2/37);评估了安全性的研究占40.54%(15/37)。结论:目前针灸治疗PPD多采用标准化针灸方案,以针刺联合心理干预常见,选穴原则以调神与调和气血为主,治疗频次多为每日1次;针灸缓解PPD症状可能有效。Objective:To discuss the characteristics of acupuncture diagnosis and treatment for postpartum depression(PPD)and the laws.Methods:The literature about treating PPD with acupuncture were searched from CNKI,VIP,Wanfang,PubMed and Google Scholar from 1999 to 2020,to analyze and sum up the commonly-used diagnostic standard,the classification of the disease degree,acupuncture intervention measures,the characteristics of syndrome differentiation and acupoint selection,frequency,total courses,short-term clinical effects,follow-up and the safety.Results:Among 37 included papers,45.95%(17/37)adopted the Diagnostic and Statistical Manual of Mental Disorders(DSM-IV)published by the American Psychiatric Association in 1994,and 32.43%(12/37)used the third Edition of The Chinese Classification and Diagnostic Criteria for mental Disorders(CCMD-3);72.97%(27/37)of the included literature were ambiguous at the classification of depression;24.32%(9/37)of the therapy commonly used acupuncture and psychological therapy,the next,21.62%(8/37)adopted acupuncture and herbs;75.68%(28/37)adopted standardized regimen mostly;the common syndrome was liver stagnation pattern,occupying 13.51%(5/37);11 commonly used acupoints were Baihui(DU20),Taichong(LR3),Zusanli(ST36),Neiguan(PC6),Sanyinjiao(SP6),Shenmen(HT7),Qimen(LR14),Sishencong,Xinshu(BL15),Pishu(BL49)and Guanyuan(CV4);45.95%(17/37)of literature performed acupuncture therapy mostly once each day;total course of the treatment was six weeks,reaching 45.95%(17/37);the effective rate was between 76.9%and 97.6%;the follow-up rate was not high,only holding 5.41%(2/37);40.54%(15/37)of the studies evaluated the safety.Conclusion:At present,acupuncture therapy for PPD mostly adopt standardized acupuncture regimen,commonly acupuncture combined with psychological intervention,regulating the mind,harmonizing Qi and blood as acupoint selection principle,once each day;acupuncture might be effective in alleviating PPD symptoms.

关 键 词：抑郁症 产后 针灸疗法 诊疗特点 文献分析 

分 类 号：R246[医药卫生—针灸推拿学]