耳穴贴压联合耳迷走神经电刺激治疗轻中度产后抑郁症的疗效及对患者心理状态和生活质量的影响

Effects of auricular point sticking combined with auricular vagus nerve stimulation on mild to moderate postpartum depression

目的观察耳穴贴压联合耳迷走神经电刺激治疗对轻中度产后抑郁症(PPD)患者的疗效及对患者心理状态和生活质量的影响。方法将70例轻中度PPD患者按照随机数字表法分为2组。对照组35例予盐酸文拉法辛胶囊治疗,治疗组35例在对照组治疗基础上予耳穴贴压联合耳迷走神经电刺激。2组均治疗8周。比较2组治疗前后17项汉密尔顿抑郁量表(HAMD-17)、抑郁自评量表(SDS)、爱丁堡产后抑郁量表(EPDS)、匹兹堡睡眠质量指数(PSQI)、生活质量综合评定问卷(GQOLI-74)评分,并统计2组疗效。结果治疗组总有效率94.29%(33/35),对照组总有效率74.29%(26/35),治疗组临床疗效优于对照组(P<0.05)。2组治疗后HAMD-17、SDS、EPDS评分均较本组治疗前降低(P<0.05),且治疗组治疗后HAMD-17、SDS、EPDS评分均低于对照组(P<0.05)。2组治疗后PSQI评分均较本组治疗前降低(P<0.05),且治疗组治疗后PSQI评分低于对照组(P<0.05)。2组治疗后GQOLI-74的社会功能、心理功能、躯体功能评分均较本组治疗前升高(P<0.05),且治疗组治疗后以上评分均高于对照组(P<0.05)。结论耳穴贴压联合耳迷走神经电刺激可以明显降低轻中度PPD患者产后抑郁状态,改善其睡眠和生活质量,值得临床推广应用。

Objective To observe the effects of auricular point sticking(APS)combined with auricular vagus nerve stimulation(aVNS)on psychological state and quality-of-life in patients with mild to moderate postpartum depression(PPD).Methods Totally 70 patients with mild to moderate PPD were randomly divided into the control group(n=35)and the treatment group(n=35).All patients were managed by venlafaxine hydrochloride capsules,and those in the treatment group were additionally treated with APS combined with aVNS.The treatment continued for 8 weeks,17-item Hamilton Depression Rating Scale(HAMD-17),self-rating depressive scale(SDS),Edinburgh Postpartum Depression Scale(EPDS),pittsburgh sleep quality index(PSQI),quality of life questionnaire(GQOLI-74)were included as comparators;the curative effect was assessed.Results The overall effective rate in the treatment group was better than that in the control group(94.29%[33/35]vs 74.29%[26/35],[P<0.05],respectively).After treatment,HAMD-17,SDS,EPDS in groups were decreased(P<0.05),the treatment group was more common(P<0.05);PSQI scores in groups were decreased(P<0.05),which were decreased in the treatment group compared with the control group(P<0.05);GQOLI-74(social function,psychological function,physical function and material life)scores in groups were increased(P<0.05),the treatment group was more prevalent(P<0.05).Conclusion For patients with mild to moderate PPD,APS combined with aVNS can significantly relieve postpartum depression,improve their sleep and quality-of-life,with worthy of clinical application.