平肝解郁汤对产妇产后抑郁症的改善及对性激素水平的影响
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摘要
目的:探讨平肝解郁汤对产妇产后抑郁症(PPD)的改善及对性激素水平的影响。方法:选取2016年10月至2018年8月濮阳市第三人民医院收治的PPD患者102例作为研究对象,按照随机数字表法随机分为观察组和对照组,每组51例。2组患者均给予心理疏导,观察组在此基础上增加平肝解郁汤治疗,2组均连续治疗3个月。比较2组患者治疗后临床疗效、治疗前后EPDS、HAMD评分、中医临床症状改善情况及性激素水平。结果:治疗后观察组总有效率明显高于对照组(P <0. 05)。与治疗前比较,治疗后2组患者EPDS、HAMD及心情抑郁等各项中医临床症状评分均明显降低,且观察组明显低于对照组(P <0. 01)。与治疗前比较,治疗后2组患者血清E_2水平明显升高,且观察组明显高于对照组(P <0. 01); 2组P水平明显降低,且观察组明显低于对照组(P <0. 01)。结论:在心理疏导的基础上给予平肝解郁汤治疗可更明显地调节PPD患者性激素水平,改善患者焦虑情绪及各项中医临床症状,提高整体治疗效果,建议临床推广使用。
Objective: To explore the improvement of Pinggan Jieyu Decoction on postpartum depression( PPD) and its influence on levels of sex hormone. Methods: A total of 102 patients with PPD who were treated in Puyang Third People's Hospital from October 2016 to August 2018 were selected and divided into the observation group and the control group using random number table method,with 51 cases in each group. The patients in the 2 groups were given psychological counseling. The observation group added Pinggan Jieyu Decoction on this basis. The 2 groups were treated continuously for 3 months. The clinical efficacy after treatment,the scores of EPDS,HAMD,the improvement of clinical symptoms of TCM and the levels of sex hormones were compared before and after treatment between the 2 groups. Results: After treatment,the total effective rate of the observation group was significantly higher than that of the control group( P < 0. 05). Compared with before treatment,the scores of EPDS,HAMD and clinical symptoms of TCM such as mood depression significantly decreased,and the observation group was significantly lower than the control group( P < 0. 01). Compared with before treatment,the levels of serum E_2 significantly increased in the 2 groups after treatment,and the observation group was significantly higher than the control group( P < 0. 01); the levels of P significantly decreased,and the observation group was significantly lower than the control group( P < 0. 01). Conclusion: Using Pinggan Jieyu decoction on the basis of psychological counseling can significantly regulate the levels of sex hormone in patients with PPD,improve the anxiety and various clinical symptoms of TCM of patients,and enhance the overall treatment effect,which is recommend to use in clinic.
Objective: To explore the improvement of Pinggan Jieyu Decoction on postpartum depression( PPD) and its influence on levels of sex hormone. Methods: A total of 102 patients with PPD who were treated in Puyang Third People's Hospital from October 2016 to August 2018 were selected and divided into the observation group and the control group using random number table method,with 51 cases in each group. The patients in the 2 groups were given psychological counseling. The observation group added Pinggan Jieyu Decoction on this basis. The 2 groups were treated continuously for 3 months. The clinical efficacy after treatment,the scores of EPDS,HAMD,the improvement of clinical symptoms of TCM and the levels of sex hormones were compared before and after treatment between the 2 groups. Results: After treatment,the total effective rate of the observation group was significantly higher than that of the control group( P < 0. 05). Compared with before treatment,the scores of EPDS,HAMD and clinical symptoms of TCM such as mood depression significantly decreased,and the observation group was significantly lower than the control group( P < 0. 01). Compared with before treatment,the levels of serum E_2 significantly increased in the 2 groups after treatment,and the observation group was significantly higher than the control group( P < 0. 01); the levels of P significantly decreased,and the observation group was significantly lower than the control group( P < 0. 01). Conclusion: Using Pinggan Jieyu decoction on the basis of psychological counseling can significantly regulate the levels of sex hormone in patients with PPD,improve the anxiety and various clinical symptoms of TCM of patients,and enhance the overall treatment effect,which is recommend to use in clinic.
引文
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[11]任胜洪,石燕芳,李青,等.解郁平肝汤治疗高血压合并焦虑症肝郁化火型的临床观察[J].世界中医药,2017,12(6):1294-1297.
[12]Osborne L,Clive M,Kimmel M,et al.Replication of Epigenetic Postpartum Depression Biomarkers and Variation with Hormone Levels[J].Neuropsychopharmacology,2016,41(6):1648-1658.
[13]王丽华,杜莹,陶新洁,等.产后抑郁症与雌二醇、催乳素、孕酮、五羟色胺水平的相关性研究[J].哈尔滨医药,2015,35(6):442-444.
[14]左宇,孔娜,刘威.80例产后抑郁症患者催乳激素、雌二醇、孕酮水平的变化[J].中国妇幼保健,2017,32(18):4355-4357.
[2]许芳,唐启盛.益肾调气法改善产后抑郁症肾虚肝郁型中医证候的临床观察[J].北京中医药,2016,35(1):72-75.
[3]乐杰.妇产科学[M].7版.北京:人民卫生出版社,2008:219-220.
[4]王永炎,严世芸.实用中医内科学[M].上海:上海科学技术出版社,2009:187-187.
[5]周丽荧,兰苏平,施敏伟.产后抑郁相关因素探讨及认知功能护理干预效果分析[J].现代实用医学,2017,29(7):968-970.
[6]Zhang Y,Jin S.The impact of social support on postpartum depression:The mediator role of self-efficacy[J].J Health Psychol,2016,21(5):720-726.
[7]许爱玲.产后抑郁症的中医证候分布规律及相关因素分析[J].西部中医药,2016,29(6):33-35.
[8]王丹,赵瑞珍,李小黎,等.补益心脾法对产后抑郁症患者中医证候积分以及雌、孕激素的影响[J].北京中医药大学学报,2015,38(11):772-776.
[9]许琳洁,郑瑀,施蕾,等.产后抑郁症的中医证型和方药规律[J].世界中医药,2017,12(7):1583-1586.
[10]杨莉.平肝解郁汤联合心理调节和西药治疗产后抑郁症41例[J].中医研究,2016,29(8):30-32.
[11]任胜洪,石燕芳,李青,等.解郁平肝汤治疗高血压合并焦虑症肝郁化火型的临床观察[J].世界中医药,2017,12(6):1294-1297.
[12]Osborne L,Clive M,Kimmel M,et al.Replication of Epigenetic Postpartum Depression Biomarkers and Variation with Hormone Levels[J].Neuropsychopharmacology,2016,41(6):1648-1658.
[13]王丽华,杜莹,陶新洁,等.产后抑郁症与雌二醇、催乳素、孕酮、五羟色胺水平的相关性研究[J].哈尔滨医药,2015,35(6):442-444.
[14]左宇,孔娜,刘威.80例产后抑郁症患者催乳激素、雌二醇、孕酮水平的变化[J].中国妇幼保健,2017,32(18):4355-4357.