自拟养血疏肝方联合心理干预治疗产后抑郁

Clinical study on treatment of postpartum depression by self-made Yangxue-Shugan decoction combined with psychological intervention

目的评价自拟养血疏肝方联合心理干预治疗产后抑郁的疗效。方法将符合入选标准的90例产后抑郁患者采用随机数字表法分为2组,每组45例。对照组口服盐酸阿米替林片,治疗组口服自拟养血疏肝方联合心理干预。2组均治疗28 d。采用症状分级量表对症状、体征进行评分,采用爱丁堡产后抑郁量表(Edinburgh Postpartum Depression Scale,EPDS)评价抑郁程度,采用放射免疫法测定血清雌二醇、孕酮、孤啡肽,采用HPLC法测定5-羟色胺,评价临床疗效。结果治疗组总有效率为95.6%(43/45)、对照组为80.0%(36/45),2组比较差异有统计学意义(Z=-2.462,P=0.014)。治疗后,治疗组情绪低落、胁肋胀痛、食少纳呆、失眠多梦评分低于对照组(t值分别为-2.337、-2.169、-2.774、-2.826,P值<0.05),雌二醇[(231.93±8.25)pg/ml比(197.46±8.72)pg/ml,t=-2.273]、5-羟色胺[(1.90±0.36)μmol/L比(1.39±0.27)μmol/L,t=-2.016]水平高于对照组(P<0.05),孕酮[(16.20±2.49)ng/ml比(27.61±2.97)ng/ml,t=-2.378]、孤啡肽[(9.94±2.03)ng/L比(15.62±3.38)ng/L,t=-2.137]水平低于对照组(P<0.05),EPDS评分[(7.7±2.4)分比(11.6±4.2)分,t=-2.449]低于对照组(P<0.05)。结论自拟养血疏肝方联合心理干预可改善产后抑郁患者的抑郁状态,减轻临床症状,提高疗效。

ObjectiveTo observe the clinical effect of Yangxue-Shugan decoction combined with psychological intervention on postpartum depression. Methods9 A total of 90 patients with postpartum depression were randomly divided into control group and treatment group (45 in each group). The control group was treated with amitriptyline. The treatment group was treated with Yangxue-Shugan decoction and psychological intervention. Both groups were treated for 28 days. Symptoms and signs were scored the symptom classification scale. The degree of depression was evaluated by the Edinburgh postpartum depression scale (EPDS). The Serum estradiol, progesterone, orphanin were measured by radioimmunoassay. The 5-hydroxytryptamine was determined by high performance liquid chromatography. ResultsThe total effective rate was 95.56% (43/45) in the treatment group and 80.00% (36/45) in the control group. The difference of the total effective rate between the two groups was statistically significant (Z=-2.462, P=0.014). After treatment, the levels of depression score (0.85 ± 0.63 vs. 1.47 ± 0.58, t=-2.337), flank pain score (0.50 ± 0.31 vs. 0.96 ± 0.43, t=-2.169), loss of appetite score (0.67 ± 0.39 vs. 1.20 ± 0.36,t=-2.774), insomnia with multiple dreams score (0.69 ± 0.43 vs. 1.18 ± 0.56, t=-2.826) in the treatment group were significantly lower than those in the control group (P<0.05). The levels of progesterone (16.20 ± 2.49 ng/ml vs. 27.61 ± 2.97 ng/ml, t=-2.378), orphanin (9.94 ± 2.03 ng/L vs. 15.62 ± 3.38 ng/L, t=-2.137), EPDS score (7.7 ± 2.4 vs. 11.6 ± 4.2, t=-2.449) in the treatment group were significantly lower than those in the control group (P<0.05). While the estradiol (231.93 ± 8.25 pg/ml vs. 197.46 ± 8.72 pg/ml, t=-2.273), 5-hydroxytryptamine (1.90 ± 0.36 μmol/L vs. 1.39 ± 0.27 μmol/L, t=-2.016) in the treatment group were significantly higher than those in the control group (P<0.05). ConclusionsThe Yangxue-Shugan decoction and psychological intervention in the treatment of postpartum depression can improve the depression status of postpartum depression patients, reduce clinical symptoms and improve clinical efficacy.