半刺治疗抑郁症刍议
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摘要
抑郁症以显著而持久的心境低落为主要临床特征,是心境障碍的主要类型。研究认为其发病与下丘脑-垂体-肾上腺轴(HPA轴)功能紊乱有密切联系。从中医学角度看,抑郁症的根本病机在于气机郁滞,从肺论治是治疗抑郁症的主要思路之一。半刺治疗抑郁症临床疗效确切。从半刺对HPA轴及肺的影响两个角度进行探讨,认为半刺治疗抑郁症的可能机制是:(1)半刺抑制了亢进的HPA轴及相关激素促肾上腺皮质激素释放激素(CRH)、促肾上腺皮质激素(ACTH)、皮质醇/皮质酮(CORT)水平;(2)开宣肺气,助肺调畅气机,从而治疗抑郁症。
Depression,also known as depressive disorder,characterized by significant and prolonged mood depression as the main clinical feature,is the main type of mood disorder. According to some study,the occurrence is closely related to the dysfunction of the hypothalamic-pituitary-adrenal axis(HPA axis). From the perspective of traditional Chinese medicine(TCM),the underlying pathogenesis of depression is qi stagnation.Treatment of the lungs is one of the main ideas for the treatment of depression. The clinical efficacy of half needling for depression is good and definite. From the influence of half needling on the HPA axis and the lungs,it is considered that the possible mechanism of half needling for depression is as follows :(1) Half needling suppresses the hyperactive HPA axis and related hormones like corticotrophin releasing hormone(CRH) and adrenocorticotropic hormone(ACTH),cortisol/corticosterone(CORT) levels;(2)Half needling disperses lung qi,assist lungs to regulate qi activity,thus playing a role in the treatment of depression.
Depression,also known as depressive disorder,characterized by significant and prolonged mood depression as the main clinical feature,is the main type of mood disorder. According to some study,the occurrence is closely related to the dysfunction of the hypothalamic-pituitary-adrenal axis(HPA axis). From the perspective of traditional Chinese medicine(TCM),the underlying pathogenesis of depression is qi stagnation.Treatment of the lungs is one of the main ideas for the treatment of depression. The clinical efficacy of half needling for depression is good and definite. From the influence of half needling on the HPA axis and the lungs,it is considered that the possible mechanism of half needling for depression is as follows :(1) Half needling suppresses the hyperactive HPA axis and related hormones like corticotrophin releasing hormone(CRH) and adrenocorticotropic hormone(ACTH),cortisol/corticosterone(CORT) levels;(2)Half needling disperses lung qi,assist lungs to regulate qi activity,thus playing a role in the treatment of depression.
引文
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[10]张天奎.梅花针叩刺督脉经穴为主治疗抑郁症46例[J].中国针灸,2009,29(9):694.
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[13]黄莉莎,王丹琳,王成伟,等.滚针治疗非器质性慢性失眠症患者90例临床研究[J].中医杂志,2007,48(4):331-334.
[14]罗玲,胡幼平,余曙光,等.滚针治疗失眠症临床疗效研究[J].中国针灸,2006,26(3):183-185.
[15]朱兵.系统针灸学:复兴“体表医学”[M].北京:人民卫生出版社,2015:325-340.
[16]郭红卫,郝飞.皮肤HPA轴的研究进展[J].中国皮肤性病学杂志,2009,23(12):841-843.
[17]陈波,李明月,丁沙沙,等.针刺调节神经-内分泌-免疫网络研究进展(英文)[J].世界针灸杂志,2014,24(4):49-53.
[18]尚靖.精神应激通过HPA轴调控皮肤疾病的发病机制分析及对药物发现的启示[C].石家庄:中国药学大会暨第十四届中国药师周,2014.
[19]KATSAROU-KATSARI A,SINGH L K,THEOHARIDES T C.Alopecia areata and affected skin CRH receptor upregulation induced by acute emotionaI stress[J].Dermatology,200l,203(2):157-161.
[20]谢光春,杨名己,魏大能,等.梅花针叩刺治疗斑秃的HPA轴机制探讨[J].湖南中医杂志,2016,32(12):99-101.
[21]徐虹,孙忠人,李丽萍,等.针刺治疗抑郁症及其对患者下丘脑-垂体-肾上腺轴的影响[J].中国针灸,2004,24(2):78-80.
[22]韩毳,李晓泓,李学武,等.电针“百会”、“三阴交”穴对慢性应激抑郁模型大鼠HPA轴的影响[J].北京中医药大学学报,2001,24(3):74-75.
[23]孙冬玮,王珑,孙忠人.针刺对慢性应激抑郁模型大鼠HPA轴的影响[J].上海针灸杂志,2007,26(2):32-34.
[24]乔瑞瑞,燕平,刘明菲,等.电针“百会”“神门”“太冲”穴对慢性应激抑郁模型大鼠血清ACTH、CORT的影响[J].世界中西医结合杂志,2014,9(2):156-158.
[2]WATSON S,MACKIN P.HPA axis function in mood disorde rs[J].Psychiatry,2006,5(5):166-170.
[3]RUBIN R T,PHILLIPS J J,MCCRACKEN J T,et al.Adrena gland volume in major depression relationship to basal and sti mulated pituitary-adrenal cortical axis function[J].Biological Ps ychiatry[J].1996,40(2):89.
[4]AXELSON D A,DORAISWAMY P M,BOYKO O B,et al.In vivo assessment of pituitary volume with magnetic resonance imaging and systematic stereology:Relationship to dexamethasone suppression test results in patients[J].Psychiatry Research,1992,44(1):63-70.
[5]JURNENA M F.Early-life stress and HPA axis trigger recurr ent adulthood depression[J].Epilepsy Behav,2014(38):148159.
[6]罗玲,唐勇,曾芳,等.独特的皮部治疗---滚针疗法[J].上海针灸杂志,2008,27(9):37-38.
[7]刘钧,谢继光.梅花针经验谈[J].上海针灸杂志,2004,23(4):41-41.
[8]王晓娜.大接经针法与常规针刺治疗肝气郁结型轻中度抑郁症的临床疗效比较[D].大连:大连医科大学,2017.
[9]张志伟,邓宁.梅花针叩刺法治疗抑郁症临床观察[J].国际中医中药杂志,2008,30(3):213-214.
[10]张天奎.梅花针叩刺督脉经穴为主治疗抑郁症46例[J].中国针灸,2009,29(9):694.
[11]贾爽杰.梅花针叩刺结合耳穴贴压治疗抑郁症62例[J].针灸临床杂志,2012,28(9):37-38.
[12]徐仁权.耳穴压豆、中药内服结合梅花针叩刺治疗产后抑郁症60例[J].中国民间疗法,2015,23(5):57-58.
[13]黄莉莎,王丹琳,王成伟,等.滚针治疗非器质性慢性失眠症患者90例临床研究[J].中医杂志,2007,48(4):331-334.
[14]罗玲,胡幼平,余曙光,等.滚针治疗失眠症临床疗效研究[J].中国针灸,2006,26(3):183-185.
[15]朱兵.系统针灸学:复兴“体表医学”[M].北京:人民卫生出版社,2015:325-340.
[16]郭红卫,郝飞.皮肤HPA轴的研究进展[J].中国皮肤性病学杂志,2009,23(12):841-843.
[17]陈波,李明月,丁沙沙,等.针刺调节神经-内分泌-免疫网络研究进展(英文)[J].世界针灸杂志,2014,24(4):49-53.
[18]尚靖.精神应激通过HPA轴调控皮肤疾病的发病机制分析及对药物发现的启示[C].石家庄:中国药学大会暨第十四届中国药师周,2014.
[19]KATSAROU-KATSARI A,SINGH L K,THEOHARIDES T C.Alopecia areata and affected skin CRH receptor upregulation induced by acute emotionaI stress[J].Dermatology,200l,203(2):157-161.
[20]谢光春,杨名己,魏大能,等.梅花针叩刺治疗斑秃的HPA轴机制探讨[J].湖南中医杂志,2016,32(12):99-101.
[21]徐虹,孙忠人,李丽萍,等.针刺治疗抑郁症及其对患者下丘脑-垂体-肾上腺轴的影响[J].中国针灸,2004,24(2):78-80.
[22]韩毳,李晓泓,李学武,等.电针“百会”、“三阴交”穴对慢性应激抑郁模型大鼠HPA轴的影响[J].北京中医药大学学报,2001,24(3):74-75.
[23]孙冬玮,王珑,孙忠人.针刺对慢性应激抑郁模型大鼠HPA轴的影响[J].上海针灸杂志,2007,26(2):32-34.
[24]乔瑞瑞,燕平,刘明菲,等.电针“百会”“神门”“太冲”穴对慢性应激抑郁模型大鼠血清ACTH、CORT的影响[J].世界中西医结合杂志,2014,9(2):156-158.