背俞穴温针灸联合刺络放血治疗肝郁脾虚型产后抑郁症的临床观察  

Clinical Observation on the Warming-Needle Moxibustion at Back-Shu Points Combined with Blood-Letting Puncture in Treating Postpartum Depression of Liver Stagnation and Spleen Deficiency Type

作　　者：李胜利[1] 李振[2] 冯枫华[2] LI Sheng-Li;LI Zhen;FENG Feng-Hua(Dept.of Rehabilitation Medicine and Physiotherapy,Guangdong Armed Police Corps Hospital,Guangzhou 510507 Guangdong,China;Dept.of Traditional Chinese Medicine,The Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150 Guangdong,China)

机构地区：[1]武警广东总队医院康复医学与理疗科,广东广州510507 [2]广州医科大学附属第三医院中医科,广东广州510150

出　　处：《广州中医药大学学报》2024年第11期2918-2923,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20232106)。

摘　　要：【目的】观察背俞穴温针灸联合刺络放血治疗肝郁脾虚型产后抑郁症(PPD)的临床疗效。【方法】将98例肝郁脾虚型产后抑郁症患者随机分为观察组和对照组,每组各49例,对照组给予盐酸舍曲林片口服,观察组在对照组治疗的基础上,给予背俞穴温针灸联合刺络放血治疗。2组均治疗2个月。治疗2个月后,评价2组临床疗效,观察2组患者治疗前后汉密尔顿抑郁量表(HAMD)评分和爱丁堡产后抑郁量表(EPDS)评分的变化情况,以及匹兹堡睡眠质量指数量表(PSQI)评分和世界卫生组织生活质量测定量表(WHOQOL-BREF)评分的情况。比较2组患者治疗前后血清5-羟色胺(5-HT)、去甲肾上腺素(NE)、多巴胺(DA)水平以及性激素雌二醇(E2)、孕酮(P)水平的变化情况。【结果】(1)观察组总有效率为93.88%(46/49),对照组为75.51%(37/49)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的HAMD和EPDS评分均明显改善(P<0.05),且观察组在改善HAMD和EPDS评分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的PSQI评分和WHOQOL-BREF评分明显改善(P<0.05),且观察组在改善PSQI评分和WHOQOL-BREF评分方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者的血清5-HT、NE、DA水平及E2、P水平均明显改善(P<0.05),且观察组在改善血清5-HT、NE、DA水平及E2、P水平方面均明显优于对照组,差异有统计学意义(P<0.05)。【结论】背俞穴温针灸联合刺络放血治疗肝郁脾虚型产后抑郁症,有助于缓解患者的临床症状,改善患者血清神经递质和性激素水平,提高睡眠质量和生存质量,从而提高患者生活质量,临床疗效显著。Objective To observe the clinical efficacy of warming-needle moxibustion at back-shu points combined with blood-letting puncture in the treatment of postpartum depression(PPD)of liver stagnation and spleen deficiency type.Methods Ninety-eight patients with PPD of liver stagnation and spleen deficiency type were randomly divided into observation group and control group,49 patients in each group,and Sertraline Hydrochloride Tablets were given to the control group orally,while the observation group was given the combination use of warming-needle moxibustion with blood-letting puncture at back-shu points based on the treatment of the control group.Both groups were treated for two months.After two months of treatment,the clinical efficacy of the two groups was evaluated,and the changes of Hamilton Depression Scale(HAMD)and Edinburgh Postnatal Depression Scale(EPDS),as well as Pittsburgh Sleep Quality Index(PSQI)and World Health Organization Quality of Life Scale(WHOQOL)-BREF of the two groups of patients before and after treatment were observed.Changes in serum 5-hydroxytryptamine(5-HT),norepinephrine(NE),and dopamine(DA)levels,as well as levels of the sex hormones estradiol(E2)and progesterone(P)before and after treatment were compared between the two groups.Results(1)The total effective rate was 93.88%(46/49)in the observation group and 75.51%(37/49)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,the scores of HAMD and EPDS of the patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,and the difference was statistically significant(P<0.05).(3)After treatment,the scores of PSQI and WHOQOL-BREF of patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,with statistically signif

关 键 词：背俞穴 温针灸 刺络放血 肝郁脾虚型 产后抑郁症 睡眠质量 生存质量 临床观察 

分 类 号：R246.9[医药卫生—针灸推拿学]