加味疏肝解郁汤联合醒脑开窍针法治疗产后抑郁症临床研究

Clinical Study of Applying Jiawei Shugan Jieyu Decoction Combined with Xingnao Kaiqiao Acupuncture Therapy in the Treatment of Postpartum Depression

目的:观察加味疏肝解郁汤联合醒脑开窍针法治疗产后抑郁症患者的临床效果。方法:选取2015年6月~2017年1月广州市番禺区何贤纪念医院72例产后抑郁症患者,随机数字表法分为对照组与研究组,各36例。对照组采用常规西医治疗(服用帕罗西汀及盐酸阿米替林),研究组在对照组用药基础上采用疏肝解郁汤+醒脑开窍针法治疗,两组均持续治疗8周。治疗前后统计对比两组汉密尔顿抑郁量表评分(HAMD)及爱丁堡产后抑郁量表评分(EPDS)、血清性激素指标[孕酮(P)、雌二醇(E2)]水平变化情况及临床疗效、不良反应发生率、疾病复发率。结果:研究组治疗前HAMD及EPDS分值与对照组比较,差异无统计学意义(P>0.05),治疗后两组HAMD及EPDS分值较治疗前降低,且研究组各指标分值较对照组低,差异有统计学意义(P<0.05);两组治疗总有效率比较,研究组94.44%(34/36)较对照组69.44%(25/36)高,差异有统计学意义(P<0.05);研究组治疗前血清P、E2水平与对照组比较,差异无统计学意义(P>0.05),治疗后两组血清P水平较治疗前降低,E2水平较治疗前增高,且研究组血清P水平较对照组低,E2水平较对照组高,差异有统计学意义(P<0.05);两组不良反应发生率比较,研究组13.89%(5/36)与对照组11.11%(4/36)间差异无统计学意义(P>0.05);研究组治疗后1个月、2个月疾病复发率[2.78%(1/36)、5.56%(2/36)]与对照组[5.56%(2/36)、11.11%(4/36)]间差异无统计学意义(P>0.05),治疗后3个月研究组疾病复发率5.56%(2/36)较对照组25.00%(9/36)低,差异有统计学意义(P<0.05)。结论:采用加味疏肝解郁汤及醒脑开窍针法治疗产后抑郁症效果显著,可有效缓解患者抑郁程度,促使性激素水平恢复,提高治疗效果,降低疾病复发率,且不良反应发生率较低,具有安全性。

Objective： To study the clinical effect of Jiawei Shugan Jieyu Decoction combined with Xingnao Kaiqiao acupunc- ture therapy in the treatment of postpartum depression. Methods： From June 2015to January 2017, selected 72patients with post- partum depression in Panyu Hexian Memorial Hospital of Guangzhou were randomly divided into controlled group and study group, each group had 36cases. The controlled group was treated with conventional westem medicine （ taking paroxetine and amitriptyline hydrochloride）. The study group was treated with Shugan Jieyu Decoction and Xingna0 Kaiqiao acupuncture on the basis of the controlled group, the two groups were treated for 8weeks. Hamilton Depression Scale （HAMD） and Edinburgh Postnatal Depression Scale （EPDS）, Serum Sex Hormone Index [ Progesterone （P）, Estradiol （E2 ） ] levels and clinical efficacy, the incidence of adverse reactions, disease recurrence rate were statistically compared between the two groups before and after treatment. Results ： There was no significant difference in HAMD and EPDS scores between the two groups before treatment （P〉0. 05 ）, while after treatment, HAMD and EPDS scores in the two groups were lower than those before treatment, and the study group was lower than that of the controlled group, the difference was statistically significant （P〈0. 05 ）. The total effective rate of the study group 94. 44% （34/36） was higher than that of the controlled group 69.44% （25/36）, the difference was statistically significant （P〈0.05 ）. There was no significant difference in serum P, E2 levels between the two groups before treatment （P〉O. 05）, while after treatment, serum P levels in both groups were lower than before treatment, and E~ levels were higher than before treatment, and serum P level in the study group was lower than that of the controlled group, E2 level was higher than the controlled group, the difference was statistically significant （P〈0. 05）. There was no significant difference in the incidence of adverse reactions between the study group 13.89% （5/36） and the controlled group 11.11% （4/36） （P〉0. 05）. There was no significant difference in recurrence rate at lmonth, 2months after treatment between the study group [2. 78% （1/36）, 5.56% （2/36） ] and the controlled group [5.56% （2/36）, 11.11% （4/36）] （P〉0. 05）, but the recurrence rate of disease in the study group was 5.56% （2/36） at 3months after treatment was lower than that of the controlled group 25.00% （9/36）, the difference was statistically significant （P〈0. 05 ）. Conclusion： Using Jiawei Shugan Jieyu Decoction combined with Xingnao Kaiqiao acupuncture therapy in the treatment of postpartum depression gets a significant effect, which can effectively relieve degree of depression, promote recovery of sex hormone, improve therapeutic effect, reduce recurrence rate and the incidence of adverse reactions is low, with security.