上海针灸杂志2017，Vol.36Issue(6)：705-710,6.DOI:10.13460/j.issn.1005-0957.2017.06.0705
针药并用对围绝经期抑郁症患者HAMD积分、SDS积分及HPO轴的影响
Effect of Acupuncture plus Medication on HAMD, SDS and H-P-O Axis in Perimenopausal Depression Patients
摘要
Abstract
Objective By observing the clinical efficacy of acupuncture plusBu Shen Jie Yu Qing Xin decoction (herbal decoction for tonifying kidney, anti-depression and clearing heart fire) in treating perimenopausal depression, to discuss about the effect of acupuncture plus medication on Hamilton Depression Scale (HAMD), Self-rating Depression Scale (SDS) and hypothalamic-pituitary-ovarian (H-P-O) axis in perimenopausal depression patients.Method By following a completely randomized design, sixty perimenopausal depression patients were divided into a Chinese medication group (Bu Shen Jie Yu Qing Xin decoction) with 30 cases, and an acupuncture-medication group (acupuncture plusBu Shen Jie Yu Qing Xin decoction) with 30 cases, to receive 12-week treatment in total. The HAMD and SDS were estimated prior to the treatment and in the 4th, 8th and 12th weeks; the serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), prolactin (PRL), and progesterone (P) contents were detected before and after the treatment.Result Acupuncture plus medication and Chinese medication alone were both effective in treating perimenopausal depression, and the therapeutic efficacy of acupuncture plus medication was superior to that of Chinese medication alone (P<0.05). In the acupuncture-medication group, the HAMD score dropped significantly in the 4th, 8th and 12th weeks compared to that before the treatment, and the score dropped significantly in the 8th and 12th weeks compared to that before the treatment in the Chinese medication group (P<0.01). The HAMD score in the acupuncture-medication group was significantly lower than that in the Chinese medication group in the 4th, 8th and 12th weeks (P<0.01). After the treatment, the items including anxiety, insight, sleep, and despair were significantly changed in the Chinese medication group (P<0.05); 7 items were significantly changed in the acupuncture-medication group (P<0.05). The scores of anxiety, insight, sleep, diurnal-nocturnal, obstruction, and body weight in the acupuncture-medication group were significantly superior to those in the Chinese medication group (P<0.05). The SDS score dropped significantly in the 4th, 8th and 12th weeks in the acupuncture-medication group, and in the 8th and 12th weeks in the Chinese medication group (P<0.01,P<0.05); in the 4th and 8th weeks, the SDS score in the acupuncture-medication group was significantly lower than that in the Chinese medication group (P<0.05), while the between-group difference was statistically insignificant in the 12th week (P>0.05). After 12-week treatment, the contents of FSH and LH declined significantly in both groups (P<0.01, P<0.05), and the contents of E2 and T increased significantly in the acupuncture-medication group (P<0.01,P<0.05). The decrease of FSH and LH, and the increase of E2 were more significant in the acupuncture-medication group (P<0.05,P<0.01).Conclusion Acupuncture plus medication can improve the symptoms of perimenopausal depression, and it takes a faster action than Chinese medication alone. Acupuncture plus medication can mitigate 7 items in HAMD, while Chinese medication can improve anxiety, insight, sleep and despair. Acupuncture plus medication can produce a more significant efficacy in improving anxiety, insight, sleep, diurnal-nocturnal, obstruction, and body weight compared to Chinese medication. For perimenopausal depression, acupuncture plus medication can correct the endocrine disorder and improve depression state by down-regulating the levels of FSH and LH, and up-regulating the contents of E2 and T to improve the function of H-P-O axis.关键词
抑郁症,围绝经期/针药并用/HAMD/SDS/HPO轴Key words
Depression,perimenopausal/Acupuncture medication combined/HAMD/SDS/H-P-O axis分类
医药卫生引用本文复制引用
黄宏丽,沈捷雯,董亚兰,董莉..针药并用对围绝经期抑郁症患者HAMD积分、SDS积分及HPO轴的影响[J].上海针灸杂志,2017,36(6):705-710,6.基金项目
国家中医药管理局"朱氏妇科流派传承研究工作室"项目 （）
上海市进一步加快中医药事业发展三年行动计划朱氏妇科流派传承研究基地(ZY-CCCX-1-1013) （ZY-CCCX-1-1013）
上海市科委自然基金项目(16ZR1438000) （16ZR1438000）
上海市中医药发展三年行动计划项目(ZYSNXD-CC-ZDYJ051) （ZYSNXD-CC-ZDYJ051）
