针刺十三鬼穴联合开心散治疗围绝经期轻度抑郁症疗效观察

Therapeutic effect on mild perimenopausal depression treated with acupuncture at the "thirteen ghost points" and kaixin powder

目的:比较针刺十三鬼穴联合开心散与单纯开心散治疗围绝经期抑郁症的临床疗效。方法:将60例围绝经期轻度抑郁症患者随机分为中药组(30例,脱落2例)与针药组(30例)。中药组口服开心散加减治疗,每日1剂,早晚分服;针药组在中药组治疗基础上,加用针刺孙思邈十三鬼穴(水沟、少商、隐白、大陵、申脉、颊车、承浆、劳宫、上星等穴),得气后即出针,隔日1次,每周3次,两组均连续治疗12周。分别于治疗前、治疗后、治疗结束后1个月随访观察两组汉密尔顿抑郁量表(HAMD)评分、抑郁自评量表(SDS)评分、围绝经期Kupperman评分,治疗12周后比较两组临床疗效。结果:治疗后、随访时,两组HAMD、SDS、Kupperman评分均较治疗前明显降低(P<0.05),且针药组均低于中药组(P<0.05)。针药组总有效率为90.0%(27/30),优于中药组的78.6%(22/28,P<0.05)。结论:针刺十三鬼穴联合开心散与单纯运用开心散均可改善围绝经期抑郁症症状,但针药结合疗效优于单纯开心散。

Objective To compare the clinical therapeutic effect on perimenopausal depression between the combined treatment with acupuncture at the "thirteen ghost points" and kaixin powder and the single application of kaixin powder. Methods A total of 60 patients with mild perimenopausal depression were randomized into a Chinese medication group(30 cases, 2 cases dropped off) and a combined treatment group(acupuncture and Chinese medication, 30 cases). In the Chinese medication group, the modified kaixin powder was administered, one dose a day, taking in the morning and the evening separately. In the combined treatment group, on the base of the treatment as the Chinese medication group, acupuncture was applied to the "thirteen ghost points" invented by SUN Si-miao, e.g. Shuigou(GV 26), Shaoshang(LU 11), Yinbai(SP 1), Daling(PC 7), Shenmai(BL 62), Jiache(ST 6), Chengjiang(CV 24), Laogong(PC 8), Shangxing(GV 23), etc. The needles were withdrawed after the qi was acquired, and acupuncture was given once every two days, 3 times a week. In both of the groups, the consecutive treatment for 12 weeks was required. Separately, before treatment, after treatment and in 1-month follow-up visit, the score of the Hamilton depression scale(HAMD), the score of the self-rating depression scale(SDS) and the score of the perimenopausal Kupperman were observed in the two groups. In 12 weeks of treatment, the clinical therapeutic effect was compared between the two groups. Results After treatment and during the follow-up, HAMD, SDS and Kupperman scores were all reduced obviously as compared with those before treatment in the two groups(P<0.05). These scores in the combined treatment group were all lower than those in the Chinese medication group(P<0.05). The total effective rate was 90.0%(27/30) in the combined treatment group, better than 78.6%(22/28) in the Chinese medication group(P<0.05). Conclusion Either the combined treatment with acupuncture at the "thirteen ghost points" and kaixin powder or the single application of kaixin powder is effective on perimenopausal depression. The therapeutic effect of the combined treatment of acupuncture and Chinese medication is superior to the simple application of kaixin powder.