健脾舒肝方联合认知行为疗法治疗产后抑郁症临床研究  

Clinical Study on Jianpi Shugan Prescription Combined with Cognitive Behavioral Therapy for Postpartum Depression

作　　者：高超 张军会[2] 宋晓飞[3] GAO Chao;ZHANG Junhui;SONG Xiaofei(Department of Integrated Traditional Chinese and Western Medicine,Nanyang Fourth People's Hospital,Nanyang Henan 473006,China;School of Clinical Medicine,Nanyang Medical College,Nanyang Henan 473004,China;Department of Rehabilitation,Nanyang Central Hospital,Nanyang Henan 473005,China)

机构地区：[1]南阳市第四人民医院中西医结合科,河南南阳473006 [2]南阳医学高等专科学校临床系,河南南阳473004 [3]南阳市中心医院康复科,河南南阳473005

出　　处：《新中医》2025年第7期99-104,共6页New Chinese Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200901)。

摘　　要：目的:观察健脾舒肝方联合认知行为疗法治疗产后抑郁症(PPD)的临床疗效。方法:选取2022年6月—2023年6月在南阳市第四人民医院治疗的86例PPD患者,按治疗方法不同分为对照组39例和研究组47例。对照组使用西酞普兰联合认知行为疗法治疗,研究组使用健脾舒肝方联合认知行为疗法治疗。2组均治疗8周。比较2组治疗前后的神经递质[5-羟色胺(5-HT)、去甲肾上腺素(NE)和多巴胺(DA)]水平,健康调查量表(SF-36)评分[社会功能(SF)、精神健康(MH)以及生理机能(PF)],认知功能[蒙特利尔认知评估量表(MoCA)评分],抑郁状态[爱丁堡产后抑郁量表(EPDS)评分],婴儿照顾能力(照顾知识、照顾能力、照顾技术)评分,匹兹堡睡眠质量指数(PSQI)(睡眠效率、入睡时间、日间功能障碍)评分,孕酮(P)、雌二醇(E2)、皮质醇(COR)水平。结果:治疗后,2组神经递质(NE、5-HT、DA)水平,SF-36(SF、MH、PF)评分,MoCA评分,婴儿照顾能力(照顾知识、照顾能力、照顾技术)评分,P、E2水平均较治疗前升高,2组睡眠效率评分、入睡时间评分、日间功能障碍评分,EPDS评分,COR水平均较治疗前降低,差异均有统计学意义(P<0.05)。研究组神经递质(NE、5-HT、DA)水平,SF-36(SF、MH、PF)评分,MoCA评分,婴儿照顾能力(照顾知识、照顾能力、照顾技术)评分,P、E2水平均高于对照组,研究组睡眠效率评分、入睡时间评分、日间功能障碍评分,EPDS评分,COR水平均低于对照组,差异均有统计学意义(P<0.05)。结论:健脾舒肝方联合认知行为疗法治疗PPD效果更好,可改善认知功能,减轻抑郁症状,提高婴儿照顾能力,提升睡眠质量,调节激素水平。Objective:To investigate the clinical effects of Jianpi Shugan Prescription combined with cognitive behavioral therapy(CBT)in treating postpartum depression(PPD).Methods:A total of 86 patients with PPD treated at the Nanyang Fourth People's Hospital from June 2022 to June 2023 were selected,according to the treatment method,it was divided into a control group(39 cases)and a study group(47 cases).The control group was treated with citalopram combined with CBT,while the study group was treated with Jianpi Shugan Prescription combined with CBT.The treatment duration was eight weeks for both groups.Levels of neurotransmitters[serotonin(5-HT),norepinephrine(NE),and dopamine(DA)],SF-36 scores[social functioning(SF),mental health(MH),and physical functioning(PF)],cognitive function[Montreal Cognitive Assessment(MoCA)scores],depressive status[Edinburgh Postnatal Depression Scale(EPDS)scores],infant caregiving ability(care knowledge,care ability,and care skills)scores,Pittsburgh Sleep Quality Index(PSQI)scores(sleep efficiency,sleep latency,and daytime dysfunction),and levels of progesterone(P),estradiol(E2),and cortisol(COR)were compared between the two groups before and after treatment.Results:After treatment,levels of neurotransmitters(NE,5-HT,and DA),SF-36 scores(SF,MH,and PF),MoCA scores,infant caregiving ability scores(care knowledge,care ability,and care skills),and levels of P and E2 were increased in the two groups compared to those before treatment(P<0.05).Sleep efficiency scores sleep time scores,and daytime dysfunction scores,EPDS scores,and COR levels were decreased,in both groups compared to those before treatment(P<0.05).The study group showed higher levels of neurotransmitters(NE,5-HT,and DA),SF-36 scores(SF,MH,and PF),MoCA scores,infant caregiving ability scores(care knowledge,care ability,and care skills),and levels of P and E2 than the control group(P<0.05).The study group had lower sleep efficiency scores,lower sleep time scores,lower daytime dysfunction scores,lower EPDS scores,and lower COR levels th

关 键 词：产后抑郁症 健脾舒肝方 认知行为疗法 爱丁堡产后抑郁量表 神经递质 婴儿照顾能力 

分 类 号：R277.7[医药卫生—中医学]