益肾健脾针刺法辅助文拉法辛治疗产后抑郁症的疗效观察及对瘦素、孤啡肽水平的影响

目的观察益肾健脾针刺法辅助文拉法辛治疗产后抑郁症(PPD)的临床疗效及对血清瘦素、孤啡肽水平的影响。方法92例PPD患者以随机数字表将患者随机分为研究组和对照组,每组46例。对照组予以文拉法辛治疗,研究组予以益肾健脾针刺法辅助文拉法辛治疗,均治疗4周。比较两组临床疗效、不良反应与治疗前后汉密尔顿抑郁量表(HAMD)评分、中医证候评分、血清瘦素、血浆孤啡肽、血清神经内分泌功能指标多巴胺(DA)、5-羟色胺(5-HT)、促甲状腺激素(TSH)、雌二醇(E2)]水平。结果研究组总有效率高于对照组(P<0.05)。治疗后,研究组HAMD评分、中医证候评分、血浆孤啡肽、血清TSH水平低于对照组(P<0.05),研究组血清瘦素、DA、5-HT、E2水平高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论益肾健脾针刺法辅助文拉法辛治疗PPD,可显著降低患者抑郁程度,改善临床症状,调节血瘦素、孤啡肽、DA、5-HT、E2、TSH水平。

Efficacy Observation of Kidney-invigorating and Spleen-reinforcing Acupuncture plus Venlafaxine forPostpartum Depression and Its Effect on Leptin and Orphanin Levels

Objective To observe the clinical efficacy of kidney-invigorating and spleen-reinforcing acupuncture plus Venlafaxine for postpartum depression(PPD)and its effect on serum leptin and orphanin levels.Method Ninety-two PPD patients were allocated,using a random number table,to study and control groups,with 46 cases in each group.The control group was treated with Venlafaxine and the study group,with kidney-invigorating and spleen-reinforcing acupuncture plus Venlafaxine.Both groups were treated for four weeks.The clinical therapeutic effects,adverse reactions,and pre-treatment and post-treatment Hamilton Depression Scale(HAMD)scores,TCM syndrome scores,serum leptin and orphanin levels and serum neuroendocrine function indicatordopamine(DA),5-hydroxytryptamine(5-HT),serum thyroid stimulating hormone(TSH)and estradiol(E2)]levels were compared between the two groups.Result The total efficacy rate was higher in the study group than in the control group(P<0.05).After treatment,the HAMD score,the TCM syndrome score,plasma orphanin levels and serum TSH levels were lower and serum leptin,DA,5-HT and E2 levels were higher in the study group than in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Kidney-invigorating and spleen-reinforcing acupuncture plus Venlafaxine can markedly reduce depression severity,relieve the clinical symptoms and regulate blood leptin,orphanin,DA,5-HT,E2 and TSH levels in treating PPD patients.