摘要
【目的】观察龙砂开阖六气针法联合黄连温胆汤加味治疗痰热内扰型围绝经期抑郁的临床疗效。【方法】将60例痰热内扰型围绝经期抑郁患者随机分为对照组和治疗组,每组各30例,对照组给予氟哌噻吨美利曲辛片口服,治疗组给予龙砂开阖六气针法联合黄连温胆汤加味治疗,4周为1个疗程,连续治疗2个疗程。治疗8周后,评价2组临床疗效,观察2组患者治疗前后汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)评分的变化情况,以及改良Kupperman(KI)评分、痰热内扰证评分的情况,比较2组患者治疗前后神经递质5-羟色胺(5-HT)、去甲肾上腺素(NE)、多巴胺(DA)、γ-氨基丁酸(GABA)、甘氨酸(Gly)水平的变化情况,以及血清性激素促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)水平的变化情况。【结果】(1)治疗组总有效率为93.33%(28/30),对照组为63.33%(19/30)。治疗组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的HAMD评分与SDS评分均明显改善(P<0.05),且治疗组在改善HAMD评分与SDS评分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的KI评分、痰热内扰证评分均明显改善(P<0.05),且治疗组在改善KI评分、痰热内扰证评分方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者的血清FSH、LH、E2水平均明显改善(P<0.05),且治疗组在改善血清FSH、LH、E2水平方面明显优于对照组,差异均有统计学意义(P<0.05)。(5)治疗后,2组患者的5-HT、NE、DA、GABA、Gly水平均明显改善(P<0.05),且治疗组在改善5-HT、NE、DA、GABA、Gly水平方面均明显优于对照组,差异均有统计学意义(P<0.05)。【结论】龙砂开阖六气针法联合黄连温胆汤加味可明显减轻痰热内扰型围绝经期抑郁患者的抑郁表现,改善患者的围绝经期症状,并能调节患者的神经递质指标和血清性激素水平,疗效显著。
Objective To observe the clinical efficacy of Longsha Opening-closing Six Climate Factors Needling therapy combined with modified Huanglian Wendan Decoction in the treatment of perimenopausal depression with internal disturbance of phlegm-heat syndrome type.Methods Sixty patients with perimenopausal depression of the internal disturbance of phlegm-heat syndrome type were randomly divided into the control group and the treatment group,30 patients in each group.The control group was given oral use of Flupentixol melitoxin Tablets,while the treatment group was given Longsha Opening-closing Six Climate Factors Needling therapy combined with modified Huanglian Wendan Decoction,4 weeks as a course of treatment and both treatments lasted for 2 consecutive courses.After 8 weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in Hamilton Depression Scale(HAMD)and Depression Self-Rating Scale(SDS)scores,as well as the modified Kupperman Index(KI)score and phlegm-heat internal disturbance syndrome score in the two groups were observed before and after treatment,and the neurotransmitters such as 5-hydroxytryptamine(5-HT),norepinephrine(NE),dopamine(DA),gamma-aminobutyric acid(GABA)and glycine(Gly)levels,as well as changes in serum follicle stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)levels were compared between the two groups before and after treatment.Results(1)The total effective rate of the treatment group was93.33%(28/30)and that of the control group was 63.33%(19/30).The efficacy of the treatment group was superior to the control group in improving HAMD and SDS scores,the difference being statistically significant(P<0.05).(2)After treatment,the HAMD and SDS scores of both groups was significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving HAMD and SDS scores,the difference being statistically significant(P<0.05).(3)After treatment,the KI score and internal disturbance of phlegm-heat syndrome score of the two groups were significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving the KI score and internal disturbance of phlegm-heat syndrome score,the difference being statistically significant(P<0.05).(4)After treatment,the serum FSH,LH and E2 levels in both groups were significantly improved(P<0.05),and the treatment group was significantly superior to the control groups in improving serum FSH,LH and E2 levels,the difference being statistically significant(P<0.05).(5)After treatment,the levels of 5-HT,NE,DA,GABA and Gly in both groups was significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving the levels of 5-HT,NE,DA,GABA and Gly,the difference being statistically significant(P<0.05).Conclusion Longsha Opening-closing Six Climate Factors Needling therapy combined with modified Huanglian Wendan Decoction can significantly reduce the depressive manifestations and improve the perimenopausal symptoms of perimenopausal depressive patients with internal disturbance of phlegm-heat syndrome type,regulate the neurotransmitter indexes and serum sex hormone levels of patients with remarkable efficacy.
作者
秦璐璐
刘文琼
QIN Lu-Lu;LIU Wen-Qiong(Shandong University of Traditional Chinese Medicine,Jinan 250014 Shandong,China;The Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014 Shandong,China)
出处
《广州中医药大学学报》
CAS
2022年第6期1306-1313,共8页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(编号:81674018)
山东省中医药科技发展计划项目(编号:2017-071)
国家中医药管理局第五批全国中医临床优秀人才研修项目(编号:国中医药人教函2022[1]号)
关键词
龙砂开阖六气针法
黄连温胆汤加味
围绝经期抑郁
痰热内扰型
临床观察
Longsha Opening-closing Six Climate Factors Needling therapy
modified Huanglian Wendan Decoction
perimenopausal depression
internal disturbance of phlegm-heat syndrome type
clinical observation
作者简介
秦璐璐(1994-),女,硕士研究生,E-mail:320659463@qq.com;通信作者:刘文琼(1973-),女,博士,主任医师,硕士研究生导师,E-mail:2621504134@qq.com
