5-羟色胺再摄取抑制剂联合电针对围绝经期焦虑抑郁障碍的疗效

Effect of SSRI Combined with Electroacupuncture on Patients with Anxiety and Depression in Perimenopausal Women

目的 探究5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitor,SSRI)联合电针治疗对围绝经期焦虑抑郁障碍患者病情发展及激素分泌的影响。方法 选取2018年4月至2019年4月我院收治的134例围绝经期焦虑抑郁障碍患者,根据治疗方法的不同,将患者分为观察组和对照组,每组67例。对照组接受单纯SSRI类药物治疗,观察组接受SSRI联合电针治疗,比较两组患者治疗后焦虑抑郁发展情况及各类激素分泌水平,包括三碘甲状腺原氨酸、四碘甲状腺原氨酸、促甲状腺激素、垂体泌乳素、血清雌二醇、促黄体生成素、孕酮以及促卵泡生成素。结果 两组患者年龄、病程、体质量指数及月经状态比较,差异均无统计学意义(P均>0.05)。治疗前,两组患者汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)与汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分比较,差异均无统计学意义(P均>0.05);治疗第2、4、6周,观察组患者HAMA评分均低于对照组(P均<0.05);治疗第4、6周,观察组患者HAMD评分均低于对照组(P均<0.05)。同组治疗前后比较,两组患者治疗第2、4、6周后,HAMA、HAMD评分均逐渐降低(P<0.05)。治疗前,两组患者三碘甲状腺原氨酸、四碘甲状腺原氨酸、促甲状腺激素、垂体泌乳素、血清雌二醇、促黄体生成素、孕酮以及促卵泡生成素水平比较,差异均无统计学意义(P均>0.05);与同组治疗前比较,治疗后观察组血清雌二醇上升,促黄体生成素下降(P均<0.05),对照组血清雌二醇上升,促黄体生成素下降(P均<0.05);治疗后观察组血清雌二醇高于对照组、促黄体生成素以及促卵泡生成素均低于对照组(P均<0.05)。结论 SSRI联合电针治疗方案可有效改善围绝经期焦虑抑郁障碍患者的焦虑、抑郁状态,下调促卵泡生成素与促黄体生成素水平,提高雌激素的分泌水平。

Objective To explore the effect of selective serotonin reuptake inhibitor(SSRI)combined with electroacu-puncture on the development and hormone secretion of patients with anxiety and depression in perimenopausal women. Methods A total of 134 patients of perimenopausal women with anxiety and depression who were admitted to our hospital from April 2018 to April 2019 were selected. According to different treatment methods,the patients were divided into a observation group and a control group,with 67 cases in each group.Patients in the control group were treated with SSRI drugs alone,and patients in the observation group were treated with SSRI+electroacupuncture. The development of anxiety,depression and the secretion levels of various hormones,including triiodothyronine,tetraiodothyronine,thyroid-stimulating hormone,pituitary prolactin,serum estradiol,luteinizing hormone,progesterone and follicle stimulating generating element.Results There was no significant difference in age,course of disease,body mass index and menstrual status between the two groups of patients(P all>0.05). Before treatment,there was no significant difference in hamilton anxiety scale(HAMA)and hamilton depression scale(HAMD)scores between the two groups of patients(P all>0.05). At the second,fourth,and sixth week of treatment,the HAMA scores of the observation group were lower than those of the control group(P all <0.05). At 4 and 6 weeks,the HAMD scores of the observation group were lower than those of the control group(P all <0.05). Compared before and after treatment in the same group,the HAMA and HAMD scores of the two groups of patients gradually decreased after 2,4,and 6 weeks after treatment(P all<0.05). Before treatment,there was no statistical difference in the levels of triiodothyronine,tetraiodothyronine,thyroid-stimulating hormone,pituitary prolactin,serum estradiol,luteinizing hormone,progesterone and follicle-stimulating hormone between the two groups of patients is not statistically significant(P all>0.05). Compared with the same group before treatment,after treatment,serum estradiol in the observation group increased,luteinizing hormone decreased(P all<0.05). After treatment,serum estradiol in the observation group was higher than that in the control group,and luteinizing hormone and follicle-stimulating hormone were lower than those in the control group(P all<0.05). Conclusion SSRI combined with electro-acupuncture can effectively improve the anxiety and depression of perimenopausal women with anxiety and depression,down-regulate the levels of follicle-stimulating hormone and luteinizing hormone,and increase the secretion of estrogen.