肝经五输穴针刺放血治疗抑郁症的疗效及对血液流变学的影响Observation on Therapeutic Effect of Acupuncture of Five Shu-points of the Liver Meridian Combined with Bloodletting for Depression Patients and Concomitant Changes of Blood Rheology
谢洪武;白春艳;易洋;徐放明;宋云娥;李腊梅;唐曦;
XIE Hong-wu,BAI Chun-yan1,YI Yang,XU Fang-ming,SONG Yun-e,LI La-mei,TANG Xi(College of Chinese Medicine,Chongqing Medical University,Chongqing 400016,China;1The Second Outpatient Clinic Department of The Central Hospital of China Aerospace Corporation,Beijing 100049)
摘要(Abstract):
目的:观察肝经五输穴针刺放血治疗抑郁症的临床疗效,探讨抑郁症患者血液流变学变化与疗效的相关性。方法:将30例抑郁症患者随机分为两组,其中药物组15例,仅单纯给予药物氟西汀治疗;针刺组15例,采用肝经五输穴针刺放血治疗。在治疗前、治疗后第1、2、4、6、8周末分别用汉密尔顿抑郁量表、临床总体印象量表(CGI-SI)来评定临床疗效;治疗前及治疗结束后对两组患者进行血液流变学指标的检测。结果:两组患者的显效率差异无统计学意义(P>0.05),但治疗第6、8周CGI-SI改善方面,针刺组优于药物组(P<0.05);治疗结束后两组患者的全血高切黏度、全血低切黏度、红细胞聚集指数、纤维蛋白原等明显低于治疗前(P<0.05),但两组之间差异无统计学意义(P>0.05)。结论:肝经五输穴针刺放血治疗抑郁症的疗效确切,治疗第6周以后症状改善明显;血液流变学一定程度上反映病情变化。
Objective To observe the clinical efficacy of acupuncture of five Shu-points of the Liver Meridian plus bloodletting for depression patients and its effect on hemorheology.Methods Thirty depression outpatients were randomly and equally divided into medication and acupuncture+bloodletting groups.Patients of the medication group were treated with Fluoxetine(20 mg/d,PO.in the morning) and those of the acupuncture+bloodletting group treated by acupuncture of Xingjian(LR 2),Taichong(LR 3),Zhongfeng(LR 4) and Ququan(LR 5) first,followed by pricking Dadun(LR 1) to let a little bit of blood out.The treatment was given once every other day,two months altogether.The therapeutic effect was assessed by using Hamilton Depression Rating Scale(HAMD) and the Clinical Global Impression Scale for Severity of Illness(CGI-SI) before and 1,2,4,6,and 8 weeks after the treatment,respectively.Changes of hemorheology were detected by using a blood rheology detector.Results Of the 15 outpatients in both medication and acupuncture+bloodletting groups,6(40.00%)and 6(40.00%)were cured basically,5(33.34%) and 4(26.67%) experienced marked improvement,2(13.33%)and 3(20.00%)were improved,and 2(13.33%) and 2(13.33%)invalid,respectively.No significant difference was found between the two groups in the therapeutic effect(P>0.05).On the 6th and 8th weeks of the treatment,the CGI-SI score of the acupuncture+bloodletting group was significantly lower than that of the medication group(P<0.05),suggesting a better therapeutic effect of the acupuncture+bloodletting group.The low and high shear viscosity of whole blood,erythrocyte aggregation index and rigidity index,and fibrinogen levels of the two groups were decreased significantly after the treatment(P<0.05).No significant difference was found between the two groups in the changes of hemorheology indexes following the treatment(P>0.05).Conclusion Acupuncture of the five Shu-points of the Liver Meridian combined with bloodletting is effective in relieving depression symptoms and improving blood rheology in depression patients.
关键词(KeyWords):
抑郁症;针刺;放血;五输穴;肝经;疗效;血液流变学
Depression;Acupuncture;Bloodletting;Five Shu-points;Liver Meridian;Curative effect;Blood rheology
基金项目(Foundation): 重庆市卫生局医学科学技术研究项目(No.2008-2-65)
作者(Authors):
谢洪武;白春艳;易洋;徐放明;宋云娥;李腊梅;唐曦;
XIE Hong-wu,BAI Chun-yan1,YI Yang,XU Fang-ming,SONG Yun-e,LI La-mei,TANG Xi(College of Chinese Medicine,Chongqing Medical University,Chongqing 400016,China;1The Second Outpatient Clinic Department of The Central Hospital of China Aerospace Corporation,Beijing 100049)
DOI: 10.13702/j.1000-0607.2012.02.013
参考文献(References):
- [1]Kraft J B,Slagert S L,McGrath P J,et al.Sequence analysisof the serotonin transporter and associations with antidepres-sant response[J].Biol Psychiatry,2005,58(5):374-381.
- [2]龚绍麟.抑郁症[M].北京:人民卫生出版社,2003:1.Gong S L.Depression[M](Chin).Beijing:People’s MedicalPublishing House,2003:1.
- [3]郭旭,赵宏,王漪,等.针刺治疗抑郁症的临床研究进展[J].针刺研究,2008,33(6):416-419.Guo X,Zhao H,Wang Y,et al.Advances of clinical studieson acupuncture treatment of depression[J].Zhen Ci Yan Jiu(Acupunct Res,Chin),2008,33(6):416-419.
- [4]周仲瑛.中医内科学[M].北京:中国中医药出版社,2003.Zhou Z Y.Internal Medicine of Traditional Chinese Medicine[M](Chin).Beijing:China Press of Traditional Chinese Medi-cine,2003.
- [5]陈泽奇,胡随瑜,张海男,等.抑郁症常见中医证候标准的研究[J].中医杂志,2005,46(1):47-49.Chen Z Q,Hu S Y,Zhang H N,et al.Study on criteria forcommonly-seen TCM syndromes of depression[J].Zhong YiZa Zhi(J Trad Chin Med,Chin),2005,46(1):47-49.
- [6]中华医学会精神科分会.中国精神障碍分类与诊断标准[M].济南:山东科学技术出版社,2001:87-88.Psychiatric Branch of Chinese Medical Association.ChineseCriteria for Classification and Diagnosis of Mental Disorders[M](Chin).Jinan:Shandong Science and Technology Press,2001:87-88.
- [7]马学红,李卫东,许珂,等.电针对盐酸帕罗西汀治疗轻中度抑郁症患者起效时间及疗效的影响[J].中华行为医学与脑科学杂志,2011,20(1):4-6.Ma X H,Li W D,Xu K,et al.Effect of electroacupunctureon therapeutic effects and onset time of Paroxetine for mild ormoderate depression patients[J].Zhonghua Xing Wei Yi XueYu Nao Ke Xue Za Zhi(Chin J Behav Med Brain Sci,Chin),2011,20(1):4-6.
- [8]石学敏.针灸学[M].北京:中国中医药出版社,2007.Shi X M.Acupuncturology[M](Chin).Beijing:China Press ofTraditional Chinese Medicine,2007.
- [9]金卫东,沈莹,陈虹.抗抑郁治疗的疗效评价及各类抗抑郁药的疗效比较[J].山东精神医学,2003,16(4):248-250.Jin W D,Shen Y,Chen H.The antidepressant treatment effi-cacy evaluation and efficacy of antidepressant drugs[J].Shan-dong Jing Shen Yi Xue(Shandong Arch Psychiatry,Chin),2003,16(4):248-250.
- [10]张雄,马世发,李亚军.度洛西汀与帕罗西汀治疗抑郁症对照观察[J].中外医学研究,2011,9(1):16-17.Zhang X,Ma S F,Li Y J.A clinical control study of Duloxe-tine and Paroxetine in the treatment of depression[J].ZhongWai Yi Xue Yan Jiu(Chin Foreign Med Res,Chin),2011,9(1):16-17.
- [11]马欢.抑郁症病因病机研究探析[J].辽宁中医杂志,2005,32(6):537-538.Ma H.Analysis on researches of etiological factors and patho-genesis of depression[J].Liaoning Zhong Yi Za Zhi(LiaoningJ Trad Chin Med,Chin),2005,32(6):537-538.
- [12]王琪,赵建军.疏肝解郁法为主治疗脑卒中后抑郁90例临床观察[J].长春中医药大学学报,2007,23(2):50-51.Wang Q,Zhao J J.Treatment of 90cases of apopletic de-pression mainly by smoothing the liver and regulating the cir-culation of qi[J].Changchun Zhong Yi Yao Da Xue Xue Bao(J Changchun Univ Trad Chin Med,Chin),2007,23(2):50-51.
- [13]陈汉平.现代中医药应用与研究大系[M].上海:上海中医药大学出版社,1995:105-114.Chen H P.Major Sets of Application and Researches of Mo-dern Chinese Medicine Research and Application System[M](Chin).Shanghai:Shanghai University of Traditional ChineseMedicine Press,1995:105-114.
- [14]王晓霞,蒋成刚,冯正直.抑郁症患者局部脑功能静息态磁共振成像研究[J].第三军医大学学报,2011,33(10):1052-1055.Wang X X,Jiang C G,Feng Z Z.Regional brain functionalconnectivity of depressed patients with resting state functionalmagnetic resonance imaging[J].Di San Jun Yi Da Xue Xue Bao(J Third Milit Med Univ,Chin),2011,33(10):1052-1055.
- [15]沈渔邨.精神病学[M].北京:人民卫生出版社,1994:55-57.Shen Y C.Psychiatry[M](Chin).Beijing:People’s MedicalPublishing House,1994:55-57.
- [16]王相立,麻爱华,孙士田.氯硝西泮和氯丙咪嗪治疗强迫症的自身对照研究[J].上海精神医学,1998,10(1):30-32.Wang X L,Ma A H,Sun S T.Self-controlled study ontreatment of obsession by clonazepam and clomipramine[J].Shanghai Jing Shen Yi Xue(Shanghai Arch Psychiatry,Chin),1998,10(1):30-32.
- [17]Zadar D,Dintenfass L.Psychohaemorheology[M].NewYork:Pergamon Press,1981:97-110.
- [18]黄诚,邵胜利,柳振清.血液流变学在精神疾病治疗上的应用动态[J].四川精神卫生,1996,9(2):139-141.Huang C,Shao S L,Liu Z Q.Current state of application ofblood rheology in the treatment of psychiatric disorders[J].Sichuan Jing Shen Wei Sheng(Sichuan Mental Health,Chin),1996,9(2):139-141.
- [19]吴福喜,臧德馨,程自立.抑郁症血液流变学的研究[J].临床精神医学杂志,1998,8(6):341-343.Wu F X,Zang D X,Cheng Z L.Depression and hemorheolo-gy[J].Lin Chuang Jing Shen Yi Xue Za Zhi(J Clin Psychia-try,Chin),1998,8(6):341-343.
- [20]刘冰冰,刘强.糖尿病神经病变患者血液流变性与微循环指标分析[J].中国血液流变学杂志,2000,10(1):47-49.Liu B B,Liu Q.Diabetes mellitus neuropathy in patientswith blood rheology and microcirculation index analysis[J].Zhongguo Xue Ye Liu Bian Xue Za Zhi(Chin J Hemorheol,Chin),2000,10(1):47-49.
- 抑郁症
- 针刺
- 放血
- 五输穴
- 肝经
- 疗效
- 血液流变学
Depression - Acupuncture
- Bloodletting
- Five Shu-points
- Liver Meridian
- Curative effect
- Blood rheology
- 谢洪武
- 白春艳
- 易洋
- 徐放明
- 宋云娥
- 李腊梅
- 唐曦
XIE Hong-wu- BAI Chun-yan1
- YI Yang
- XU Fang-ming
- SONG Yun-e
- LI La-mei
- TANG Xi(College of Chinese Medicine
- Chongqing Medical University
- Chongqing 400016
- China
- 1The Second Outpatient Clinic Department of The Central Hospital of China Aerospace Corporation
- Beijing 100049)
- 谢洪武
- 白春艳
- 易洋
- 徐放明
- 宋云娥
- 李腊梅
- 唐曦
XIE Hong-wu- BAI Chun-yan1
- YI Yang
- XU Fang-ming
- SONG Yun-e
- LI La-mei
- TANG Xi(College of Chinese Medicine
- Chongqing Medical University
- Chongqing 400016
- China
- 1The Second Outpatient Clinic Department of The Central Hospital of China Aerospace Corporation
- Beijing 100049)