1.深圳市宝安中医院,广东省深圳市宝安区30区裕安二路25号,518101
2.广东省中医院
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收稿:2022-08-21,
修回:2022-11-20,
纸质出版:2023-05-02
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谢星宇,邹婧怡,阎路达等.运用疏肝调神整合针灸方案治疗产后抑郁症的思路与方法[J].中医杂志,2023,64(09):890-895.
XIE Xingyu,ZOU Jingyi,YAN Luda,et al.Thoughts and Methods of Integrated Acupuncture and Moxibustion Program in the Treatment of Postpartum Depression based on “Soothing the Liver and Regulating the Mind”[J].Journal of Traditional Chinese Medicine,2023,64(09):890-895.
谢星宇,邹婧怡,阎路达等.运用疏肝调神整合针灸方案治疗产后抑郁症的思路与方法[J].中医杂志,2023,64(09):890-895. DOI: 10.13288/j.11-2166/r.2023.09.006.
XIE Xingyu,ZOU Jingyi,YAN Luda,et al.Thoughts and Methods of Integrated Acupuncture and Moxibustion Program in the Treatment of Postpartum Depression based on “Soothing the Liver and Regulating the Mind”[J].Journal of Traditional Chinese Medicine,2023,64(09):890-895. DOI: 10.13288/j.11-2166/r.2023.09.006.
产后抑郁症属于中医学“郁病”范畴,认为肝气失常、神失所养为产后抑郁症的主要病机,提出疏肝调神的治则治法,并据此制定整合针灸治疗方案,即综合运用针刺、精灸、刺络、埋针等中医特色疗法,以“一针二灸三巩固”为方案。一针指针刺时主辨肝气虚实,肝气实则平肝气、调神志,主穴选取四关穴(太冲、合谷)、百会、印堂;肝气虚则补肝气、安神志,主穴选取太冲、内关及引气归元四穴(中脘、下脘、气海、关元)、百会、印堂。二灸指精灸和刺络法,其中精灸取细小的艾绒精准刺激穴位,以补为通,选取位于任脉的引气归元四穴(中脘、下脘、气海、关元)及巨阙、膻中为主穴;刺络为泻以调脏腑,选取五脏俞之心俞、肝俞为主穴。三巩固指运用耳穴和背俞穴埋针,其中耳穴多选取心、肝二穴,背俞穴多选取刺络五脏俞对应的五志穴。
Postpartum depression (PPD) belongs to the category of “constraint disease” in traditional Chinese medicine (TCM), and is closely related to the liver. It is believed that the liver
qi
disorder and mind loss are the main pathogenesis of PPD, and the method of “soothing the liver and regulating the mind” is recommended as the treatment principle. The integrated acupuncture and moxibustion program was formulated, that is, the comprehensive use of TCM-specific techniques such as acupuncture, fine moxibustion, collateral bloodletting, and catgut embedment in acupoint, using “acupuncture first, moxibustion next and consolidation finally” strategy. In terms of acupuncture, it is emphasized to differentiate deficiency from excess of liver
qi
; if there is excess, the liver
qi
should be calmed, and the (conscious) mind should be regulated, mainly using the four gates including bilateral Taichong (LR 3) and Hegu (LI 4), as well as Baihui (GV 20) and Yintang (GV 29); if there is deficiency, the liver
qi
should be supplemented, and the mind should be calmed, mainly using Taichong (LR 3), Neiguan (PC 6), four acupoints returning
qi
to its source which include Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6) and Guanyuan (CV 4), as well as Baihui (GV 20) and Yintang (GV 29). Subsequent moxibustion refers to fine moxibustion and collateral bloodletting; the former uses fine moxa to precisely stimulate acupoints, including four acupoints returning
qi
to its source Zhongwan (CV 12), Xiawan (CV 6), Qihai and Guanyuan (CV 4), Juque (CV 14), and Tanzhong (CV 17) in the Conception Vessel (任脉), following the principle of “to unblock with supplementation”; the latter is for drainage by regulating
zang fu
organs (脏腑), and
Xinshu
(BL 15) and
Ganshu
(BL 18) of the five
zang
-
shu
are mainly used. The final consolidation uses embedment in ear points including heart and liver, as well as back-
shu
points, mainly the the five minds aupoints corresponding to five
zang
-
shu
of collateral bloodletting.
产后抑郁防治指南撰写专家组 . 产后抑郁障碍防治指南的专家共识(基于产科和社区医生) [J]. 中国妇产科临床杂志 , 2014 , 15 ( 6 ): 572 - 576 .
MU TY , LI YH , PAN HF , et al . Postpartum depressive mood(PDM) among Chinese women:a meta-analysis [J]. Arch Womens Ment Health , 2019 , 22 ( 2 ): 279 - 287 .
KOŁOMAŃSKA-BOGUCKA D , MAZUR-BIALY AI . Phy-sical activity and the occurrence of postnatal depression:a systematic review [J]. Medicina , 2019 , 55 ( 9 ): 560 .
李佳 , 李晓璇 . 心理与心理社会干预在产后抑郁预防中的研究进展 [J]. 中国健康教育 , 2018 , 34 ( 3 ): 261 - 264 .
魏海燕 , 王君 , 邱晓玲 , 等 . 产后抑郁症病因病机及中医针灸治疗进展 [J]. 海南医学 , 2022 , 33 ( 11 ): 1472 - 1475 .
于峥 , 黄晓华 , 滕静如 , 等 . 肝主疏泄畅情志的理论内涵及临床应用 [J]. 中医杂志 , 2013 , 54 ( 22 ): 1914 - 1916 .
宋婷婷 , 景向红 , 曾炜美 , 等 . 基于产后抑郁症病机特点谈提高针刺疗效的取穴思路 [J]. 广州中医药大学学报 , 2022 , 39 ( 4 ): 860 - 864 .
滕金艳 . 调神解郁法针刺治疗郁证(肝气郁结)的临床观察 [D]. 哈尔滨 : 黑龙江中医药大学 , 2010 .
郭冰玉 , 田文杨 , 张新宁 , 等 . 从脑髓-脑神-脑气多角度探讨帕金森病 [J]. 北京中医药 , 2021 , 40 ( 8 ): 866 - 869 .
韦梦铃 , 付西 , 王玉婷 , 等 . 基于形气神一体观论中医肿瘤发生学 [J]. 中医杂志 , 2021 , 62 ( 14 ): 1197 - 1199,1204 .
符文彬 , 刘月 , 郭小川 . 整合针灸学引领针灸临床发展 [J]. 中华中医药杂志 , 2016 , 31 ( 12 ): 4897 - 4899 .
符文彬 . 整合针灸是治疗抑郁障碍难点的关键 [J]. 中国针灸 , 2018 , 38 ( 7 ): 766 .
郝石磊 , 刘静 , 王定雪 , 等 . 许建阳教授应用四关穴临床治验举要 [J]. 上海针灸杂志 , 2011 , 30 ( 12 ): 802 - 803 .
李冀 , 王晓雨 , 胡晓阳 , 等 . 针刺治疗抑郁症选穴规律的文献研究 [J]. 针灸临床杂志 , 2019 , 35 ( 4 ): 53 - 56 .
杨学琴 , 张文悦 , 马文昊 , 等 . 电针联合认知行为疗法早期干预轻度抑郁状态30例疗效观察 [J]. 中医杂志 , 2012 , 53 ( 11 ): 936 - 938,968 .
张欣怡 , 傅文 , 宁百乐 , 等 . 从气血与神的关系探究引气归元组穴治疗抑郁症 [J]. 环球中医药 , 2021 , 14 ( 7 ): 1310 - 1312 .
刘晶 , 张继福 , 符文彬 . 符文彬治疗2例多系统萎缩病例分析 [J]. 中医药通报 , 2018 , 17 ( 2 ): 40 - 43 .
王省 , 陈刚 . 试论枢转少阳与快速抗抑郁 [J]. 中医杂志 , 2017 , 58 ( 2 ): 174 - 176 .
王一中 , 严智强 , 赵玉环 , 等 . 耳穴头针刺激区体穴脏腑相关的客观化研究 [J]. 中医杂志 , 1987 , 28 ( 8 ): 56 - 58 .
杨松柏 , 梅志刚 , 谭凌菁 , 等 . 耳迷走神经分布区穴位电刺激配合声音掩蔽法对耳鸣大鼠听性脑干反应及下丘神经递质的影响 [J]. 中国针灸 , 2016 , 36 ( 5 ): 517 - 522 .
宋世运 , 王寅 . 田从豁以膀胱经二侧线为主治疗神志病经验 [J]. 湖北中医杂志 , 2009 , 31 ( 5 ): 26 - 27 .
陆倩影 , 柳亚平 . 鸠尾穴的古代文献研究 [J]. 河南中医 , 2020 , 40 ( 3 ): 466 - 469 .
ZUNG WW . A self-rating depression scale [J]. Arch Gen Psychiatry , 1965 , 12 : 63 - 70 . doi: 10.1001/archpsyc. 1965.01720310065008 http://dx.doi.org/10.1001/archpsyc.1965.01720310065008 .
ZUNG WW . A rating instrument for anxiety isorders [J]. Psychosomatics , 1971 , 12 ( 6 ): 371 - 379 .
刘贤臣 , 唐茂芹 , 胡蕾 , 等 . 匹兹堡睡眠质量指数的信度和效度研究 [J]. 中华精神科杂志 , 1996 , 29 ( 2 ): 103 - 107 .
刘岚青 , 韩玉慧 , 史芳宇 . 排针平刺法联合药物治疗卒中后抑郁疗效观察 [J]. 上海针灸杂志 , 2022 , 41 ( 10 ): 970 - 974 .
周学平 , 曹丽娟 , 颜平康 . 针刺辅助氢溴酸西酞普兰治疗老年卒中后失眠伴抑郁患者的临床效果 [J]. 中国医药导报 , 2022 , 19 ( 29 ): 90 - 93 .
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