针刺对女性更年期抑郁症患者的疗效及其对DA、NE、5-HIAA的影响

Therapeutic effect of acupuncture on female's climacteric depression and its effects on DA, NE and 5-HIAA contents

目的:观察针刺治疗女性更年期抑郁症的临床疗效,探讨针刺作用机理。方法:60例入选病例随机分为针刺组和对照组,每组各30例。针刺组穴取肝俞、肾俞、心俞等,采用平补平泻的手法,每日1次;对照组患者口服百优解20mg,每日1次。两组于治疗前及治疗的第2、4、6周末进行抗抑郁量表(HAMD)评定。两组患者分别于治疗前和1个疗程结束后检测多巴胺(DA)、去甲肾上腺素(NE)和血清5-羟吲哚乙酸(5-HIAA)的含量。结果:治疗后针刺组的总有效率是86·7%,对照组总有效率为92·9%,两组疗效比较,差异没有显著性意义(P>0·05)。治疗后针刺组DA含量明显升高(P<0·05),对照组虽有升高,但与治疗前比较差异无显著性意义(P>0·05),两组治疗后比较,差异具有显著性意义(P<0·05);治疗后两组患者的NE与5-HIAA含量均明显升高,分别与治疗前比较,差异具有显著性或非常显著性意义(P<0·05,P<0·01),但组间比较,差异没有显著性意义(P>0·05)。结论:针刺可对机体全身功能进行良性的、综合的调节,提高单胺类物质在体内的含量,从而起到抗抑郁作用。

Objective To observe therapeutic effects of acupuncture on female＇s climacteric depression and to study on the mechanism. Methods Sixty cases enrolled were randomly divided into an acupuncture group and a control group, 30 cases in each group. In the acupuncture group, acupuncture were given at Ganshu （BL 18）, Shenshu （BL 23）, Xinshu （BL 15）, etc. with uniform reinforcing-reducing method, once each day, and the control group were treated with oral administration of fluexertine hydrochloride, 20 mg, once daily. HAMD scale was used for assessment before treatment and 2,4,6 weeks after treatment. Blood dopamine （DA）, norepinephrine （NE） and 5-hydroxy-indoleacetic acid （5-HIAA） contents were detected before treatment and after one therapeutic course. Results The total effective rate was 86.7% in the acupuncture group and 92.9% in the control group with no significant difference between the two groups （P〉0.05）. After treatment, DA content increased significantly in the acupuncture group with a significant difference as compared with that of the control group （P〈0.05） ; and after treatment NE and 5-HIAA contents in the two groups significantly increased as compared with that before treatment （P〈0.05, P〈0. 01）, with no significant difference between the two groups （P〉0.05）. Conclusion Acupuncture can benignly and comprehensively regulate general functions, and increase contents of monoamines in the body, so as to play the role of anti-depression.