针药结合对围绝经期抑郁症患者神经递质的影响

摘要

目的：通过观察补肾解郁清心方结合针灸治疗围绝经期抑郁症的临床疗效，探讨针药结合治疗方法对围绝经期抑郁症患者5－HIAA、NE、DA的影响。方法将60例围绝经期抑郁症患者按照完全随机方法分为中药组（补肾解郁清心方）30例，中药＋针灸组（补肾解郁清心方＋针灸）30例，共治疗12周，治疗前后进行HAMD积分、Kupperman指数评定及血清5－HIAA、NE、DA的检测。结果针药结合与中药治疗女性围绝经期抑郁症均有效，而针药结合治疗的疗效优于单纯中药治疗（ P＜0．05）。两组治疗后HAMD积分、KMI评分均较治疗前明显下降（P＜0．01）；组间比较，针药组治疗后HAMD积分、KMI评分均低于中药组（P＜0．01， P＜0．05）。治疗后，针药组5－HIAA、NE、DA较治疗前明显升高（P＜0．01）；中药组5－HIAA、DA较治疗前均明显升高（P＜0．01），NE较治疗前升高（P＜0．05）。组间比较，针药组5－HIAA、NE升高更明显（P＜0．01，P＜0．05），DA差异无统计学意义（P＞0．05）。结论针药结合能改善患者围绝经期抑郁症相关症状，降低HAMD积分与Kupperman指数，且起效快于单纯中药治疗。针药结合干预围绝经期抑郁症，能提高5－HIAA、NE、DA等单胺类神经递质在体内的含量，使之达到抗抑郁作用。%Objective To investigate the effect of Bushen Jieyu Qingxin prescription integrating with acupuncture in treating perimenopausal depression, andto explore the effect of combining acupuncture with Chinese medicine treatment on perimenopausal depression patients '5-HIAA, NE and DA.Method Based on the inclusion criteria and exclusion criteria of perimenopausal depression , 60 patients were recruited from the outpatient departments of Gynecology and Acupuncture of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine , and they were randomly divided into Chinese medicine group of 30 cases have been treated by Bushen Jieyu Qingxin prescription for 12 weeks and integrated treatment group of 30 cases have received integrated treatment group (Chinese medicine and acupuncture group ) for 12 weeks.The HAMD, KMI, examine5-HIAA, NE, DA and the thickness of endometrium before and after treatment wereevaluated .Results Both methods had effect on perimenopausal depression , but the integrated treatment works better ( P<0.05 ) .After treatment , HAMD and KMI score of the integrated treatment group decreased obviously ( P<0.01),and group comparison showed HAMD and KMI score of the integrated treatment group were lower than those of the single group (P<0.01, P<0.05).After treatment, the serum concentration of 5-HIAA, NE and DA in the integrated group and the serum concentration of 5-HIAA and DA in the single group both increased obviously ( P<0.01) .The serum concentration of NE in the single group increased ( P<0.05).Group comparison of 5-HIAA and NE in the integrated group increased more obviously (P<0.01 and P<0.05, respectively), while the result of DA appeared no significant difference ( P >0.05 ) .Conclusion Integrated treatment can relieve the symptoms of perimenopausal depression , reduce the score of HAMD , SDS and Kupperman scale , and its effect is quicker .Integrated treatment effectively increased the amount of monoamine substances (5-HIAA, NE, DA) in vivo, and had an antidepressant effect for this reason .