针刺治疗产后抑郁症的临床研究进展
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摘要
目前,产后抑郁症(PPD)尚无明确的治疗标准。通过检索近10年的相关文献,发现针刺治疗PPD临床方法多样,具体方法有头皮针、腹针、毫针、电针及耳针等。对相关针刺治疗PPD研究文献进行进一步的分析,发现针刺治疗PPD疗效显著。其中,单纯针刺疗法治疗PPD的疗效并不弱于抗抑郁药物治疗,针刺联合口服药物、心理干预等协同疗法治疗PPD疗效比单纯针刺疗法更好。此外,虽然针刺治疗PPD在临床上已取得一定进展,但临床研究方面仍存在一定的问题,如选穴标准不一、样本量小、缺乏远期预后追踪等,需进行更加严谨合理的临床实验促进针刺治疗PPD的临床应用。
At present,there is no clear standard treatment for postpartum depression( PPD). Based on summarizing related literatures of recent years,it is found that there are various acupuncture methods for PPD,such as scalp acupuncture,abdominal acupuncture,acupuncture with filiform needle,electro-acupuncture and auricular acupuncture. Further analysis of the literature revealed that acupuncture has been found significantly effective for the treatment of PPD. The results indicated the efficacy of single acupuncture therapy was not less effective than antidepressant therapy in treating PPD. The combination of acupuncture and medication or psychotherapy has better therapeutic effect than single acupuncture therapy. Despite of therapeutic effect,there are still some problems in clinical research,such as different selection criteria for acupoints,small sample size and lack of long-term prognosis. Therefore,strict design for clinical study is needed for promoting acupuncture in treating PPD.
At present,there is no clear standard treatment for postpartum depression( PPD). Based on summarizing related literatures of recent years,it is found that there are various acupuncture methods for PPD,such as scalp acupuncture,abdominal acupuncture,acupuncture with filiform needle,electro-acupuncture and auricular acupuncture. Further analysis of the literature revealed that acupuncture has been found significantly effective for the treatment of PPD. The results indicated the efficacy of single acupuncture therapy was not less effective than antidepressant therapy in treating PPD. The combination of acupuncture and medication or psychotherapy has better therapeutic effect than single acupuncture therapy. Despite of therapeutic effect,there are still some problems in clinical research,such as different selection criteria for acupoints,small sample size and lack of long-term prognosis. Therefore,strict design for clinical study is needed for promoting acupuncture in treating PPD.
引文
[1]杨怀洁,杨成良.产后抑郁症的研究进展[J].现代妇产科进展,2015,24(1):72-74,77.
[2]常姣娥.产后抑郁症[J].国外医学·妇幼保健分册,1994,5(1):17-20.
[3] Halbreich U,Karkun S. Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms[J]. Journal of Affective Disorders,2005,91(2):97-111.
[4]王伟,白萍,冯斌,等.心理治疗对产后抑郁症的疗效观察[J].中国民康医学,2008,20(11):1181,1184.
[5]崔才三,隋京美,韩丹青.产后抑郁症病因、诊断及防治的研究进展[J].现代妇产科进展,2005,14(4):319-321.
[6]朱晓洁.产后抑郁症的病因和药物治疗现状[J].天津药学,2013,25(3):61-63.
[7]姜玉龙,赵重波.抑郁症治疗药物发展[J].上海医药,2011,32(6):267-269.
[8] Stuart S,O’hara MW,Gorman L. The prevention and psychotherapeutic treatment of postpartum depression[J]. Archives of Women’s Mental Health,2003,6(2):s57-s69.
[9]沈荣.产后抑郁现状和影响因素调查分析及其心理干预效果研究[D].太原:山西医科大学,2011.
[10] Cabyoglu MT,Ergene N,Tan U. The mechanism of acupuncture and clinical applications[J]. International Journal of Neuroscience,2006,116(2):115-125.
[11]陆晓红,林虹,陈东升.产后抑郁症的针刺干预治疗[J].针灸临床杂志,2008,24(7):13-14.
[12]黄泳.针刺治疗抑郁症的概况[J].安徽中医临床杂志,2003,15(3):251-253.
[13]张立群,李伊为.头皮针疗法与穴位全息律[J].上海针灸杂志,1996,15(5):39-40.
[14]罗和春,贾云奎,詹丽,等.电针治疗情感性精神病(抑郁状态)疗效观察[J].中国针灸,1984,4(1):1-4.
[15]罗和春,周东丰,贾云奎,等.电针治疗抑郁症临床观察与实验研究[J].北京医科大学学报,1987,29(1):45-47.
[16]罗和春,沈渔邨,贾云奎,等.电针治疗133例抑郁症患者临床疗效观察[J].中西医结合杂志,1988,8(2):68,77-80.
[17]罗和春,Halbriech U,沈渔邨,等.电针与氟西汀治疗抑郁症疗效的对照研究[J].中华精神科杂志,2003,36(4):26-30.
[18]董子平.电针治疗抑郁症101例[J].中国针灸,2001,21(1):7.
[19]许淑娟.头皮针对产后抑郁症的影响[D].广州:广州中医药大学,2010.
[20]于红娟,张巍,王晓光.腹针治疗产后抑郁症68例[J].上海针灸杂志,2015,34(3):251-252.
[21]杨秀娟,刘向,罗和春,等.针刺奇经穴为主治疗抑郁症临床观察[J].中医杂志,1992,43(3):36-38.
[22]吴北燕.针灸治疗抑郁症[J].四川中医,1996,15(9):53.
[23]陈杰,张捷,裴音.针刺治疗产后抑郁症的疗效评价[J].中国中医药信息杂志,2010,17(7):77-78.
[24]于树静,李雪青,冯小明,等.针刺十三鬼穴对产后抑郁症临床疗效及生活质量的影响[J].上海针灸杂志,2015,34(1):14-16.
[25]石淑贤,白丽敏,高永珍,等.耳针用于妊娠晚期引产疗效观察[J].中国针灸,2001,21(1):28-29.
[26]张伟范,孙沫,吕大鸣,等.耳穴电针治疗产后抑郁症43例[J].中国针灸,2012,32(12):1075-1076.
[27] Chen BT. Acupuncture at BL67 for mild postpartum depression:a prospective case series[J]. Acupuncture in Medicine,2018. DOI:10.1136/acupmed-2017-011473.
[28]林嘉祈.针药联合心理疗法治疗心脾两虚型产后抑郁症的临床研究[D].广州:广州中医药大学,2013.
[29]朱然.针灸加西药可治疗产后抑郁症[N].中国中医药报,2001-12-12(001).
[30]肖瑶,王佳佳,胡英华,等.针灸配合心理干预治疗产后抑郁症[J].长春中医药大学学报,2015,31(1):164-166.
[2]常姣娥.产后抑郁症[J].国外医学·妇幼保健分册,1994,5(1):17-20.
[3] Halbreich U,Karkun S. Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms[J]. Journal of Affective Disorders,2005,91(2):97-111.
[4]王伟,白萍,冯斌,等.心理治疗对产后抑郁症的疗效观察[J].中国民康医学,2008,20(11):1181,1184.
[5]崔才三,隋京美,韩丹青.产后抑郁症病因、诊断及防治的研究进展[J].现代妇产科进展,2005,14(4):319-321.
[6]朱晓洁.产后抑郁症的病因和药物治疗现状[J].天津药学,2013,25(3):61-63.
[7]姜玉龙,赵重波.抑郁症治疗药物发展[J].上海医药,2011,32(6):267-269.
[8] Stuart S,O’hara MW,Gorman L. The prevention and psychotherapeutic treatment of postpartum depression[J]. Archives of Women’s Mental Health,2003,6(2):s57-s69.
[9]沈荣.产后抑郁现状和影响因素调查分析及其心理干预效果研究[D].太原:山西医科大学,2011.
[10] Cabyoglu MT,Ergene N,Tan U. The mechanism of acupuncture and clinical applications[J]. International Journal of Neuroscience,2006,116(2):115-125.
[11]陆晓红,林虹,陈东升.产后抑郁症的针刺干预治疗[J].针灸临床杂志,2008,24(7):13-14.
[12]黄泳.针刺治疗抑郁症的概况[J].安徽中医临床杂志,2003,15(3):251-253.
[13]张立群,李伊为.头皮针疗法与穴位全息律[J].上海针灸杂志,1996,15(5):39-40.
[14]罗和春,贾云奎,詹丽,等.电针治疗情感性精神病(抑郁状态)疗效观察[J].中国针灸,1984,4(1):1-4.
[15]罗和春,周东丰,贾云奎,等.电针治疗抑郁症临床观察与实验研究[J].北京医科大学学报,1987,29(1):45-47.
[16]罗和春,沈渔邨,贾云奎,等.电针治疗133例抑郁症患者临床疗效观察[J].中西医结合杂志,1988,8(2):68,77-80.
[17]罗和春,Halbriech U,沈渔邨,等.电针与氟西汀治疗抑郁症疗效的对照研究[J].中华精神科杂志,2003,36(4):26-30.
[18]董子平.电针治疗抑郁症101例[J].中国针灸,2001,21(1):7.
[19]许淑娟.头皮针对产后抑郁症的影响[D].广州:广州中医药大学,2010.
[20]于红娟,张巍,王晓光.腹针治疗产后抑郁症68例[J].上海针灸杂志,2015,34(3):251-252.
[21]杨秀娟,刘向,罗和春,等.针刺奇经穴为主治疗抑郁症临床观察[J].中医杂志,1992,43(3):36-38.
[22]吴北燕.针灸治疗抑郁症[J].四川中医,1996,15(9):53.
[23]陈杰,张捷,裴音.针刺治疗产后抑郁症的疗效评价[J].中国中医药信息杂志,2010,17(7):77-78.
[24]于树静,李雪青,冯小明,等.针刺十三鬼穴对产后抑郁症临床疗效及生活质量的影响[J].上海针灸杂志,2015,34(1):14-16.
[25]石淑贤,白丽敏,高永珍,等.耳针用于妊娠晚期引产疗效观察[J].中国针灸,2001,21(1):28-29.
[26]张伟范,孙沫,吕大鸣,等.耳穴电针治疗产后抑郁症43例[J].中国针灸,2012,32(12):1075-1076.
[27] Chen BT. Acupuncture at BL67 for mild postpartum depression:a prospective case series[J]. Acupuncture in Medicine,2018. DOI:10.1136/acupmed-2017-011473.
[28]林嘉祈.针药联合心理疗法治疗心脾两虚型产后抑郁症的临床研究[D].广州:广州中医药大学,2013.
[29]朱然.针灸加西药可治疗产后抑郁症[N].中国中医药报,2001-12-12(001).
[30]肖瑶,王佳佳,胡英华,等.针灸配合心理干预治疗产后抑郁症[J].长春中医药大学学报,2015,31(1):164-166.