针刺结合麦粒灸治疗肾虚肝郁型围绝经期抑郁症临床疗效观察

目的:比较针刺结合麦粒灸与口服盐酸氟西汀胶囊治疗肾虚肝郁型围绝经期抑郁症的临床疗效。方法:将60例肾虚肝郁型围绝经期抑郁症患者随机分为观察组和对照组,每组30例。观察组采用针刺结合麦粒灸治疗,针刺穴取百会、印堂、风池等,留针30 min;麦粒灸穴取肝俞、肾俞、命门、涌泉,每穴灸3壮,均隔日1次,每周3次。对照组予口服盐酸氟西汀胶囊,每次20 mg,每天1次。两组均治疗8周。分别于治疗前后及治疗后1、3、6个月随访时观察两组患者汉密尔顿抑郁量表(HAMD)评分、改良Kupperman评分,并于治疗后评定两组临床疗效。结果:两组患者治疗后及随访时各时点HAMD评分、改良Kupperman评分均较治疗前降低(P<0.01),且观察组HAMD评分均低于对照组(P<0.01)。观察组总有效率为93.3%(28/30),优于对照组的80.0%(24/30,P<0.01)。结论:针刺结合麦粒灸可有效治疗肾虚肝郁型围绝经期抑郁症,较口服盐酸氟西汀胶囊,具有更加稳定、持续的疗效。

Therapeutic effect of acupuncture combined with wheat-grain moxibustion on perimenopausal depression with kidney deficiency and liver depression

Objective To compare the therapeutic effect of acupuncture combined with wheat-grain moxibustion and oral fluoxetine hydrochloride capsule on perimenopausal depression with kidney deficiency and liver depression.Methods A total of 60 patients of perimenopausal depression with kidney deficiency and liver depression were randomized into an observation group and a control group,30 cases in each one.Acupuncture combined with wheat-grain moxibustion were adopted in the observation group.Acupuncture was applied at Baihui(GV 20),Yintang(GV 29),Fengchi(GB 20),etc.for 30 min.Wheat-grain moxibustion was applied at Ganshu(BL 18),Shenshu(BL 23),Mingmen(GV 4)and Yongquan(KI 1),3 moxa-cones for each acupoint.The treatment in the observation group was given once every 2 days,3 times a week.Fluoxetine hydrochloride capsule was given orally in the control group,20 mg each time,once a day.Treatment for 8 weeks was required in the both groups.The scores of Hamilton depression scale(HAMD)and modified Kupperman scale were observed in the both groups before and after treatment,and at 1,3,6-month follow-up.The therapeutic efficacy was evaluated after treatment.Results Compared before treatment,the scores of HAMD and modified Kupperman scale after treatment and at each time point of follow-up were decreased in the both groups(P<0.01),and the HAMD scores in the observation group were lower than the control group(P<0.01).The total effective rate was 93.3%(28/30)in the observation group,which was superior to 80.0%(24/30)in the control group(P<0.01).Conclusion Acupuncture combined with wheat-grain moxibustion can effectively treat perimenopausal depression with kidney deficiency and liver depression,and have more stable and sustained therapeutic effect compared with oral fluoxetine hydrochloride capsule.