Objective: To observe the clinical therapeutic effect on mild and moderate postpartum depression treated with acupuncture of Tiaoren Tongdu (regulating the conception vessel and unblocking the governor vessel) on the base of real world.
Methods: A total of 116 patients with mild and moderate postpartum depression were divided into an acupuncture group (103 cases) and a non-acupuncture group (13 cases) according to treatment regimen provided. In the acupuncture group, acupuncture of Tiaoren Tongdu was applied to Baihui (GV 20), Yintang (GV 29), Zhongwan (CV 12), Qihai (CV 6), Guanyuan (CV 4), Neiguan (PC 6), Shenmen (HT 7), Hegu (LI 4), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3). Needles were retained for 30 min each time, the treatment was given once every other day, 3 times a week. In the non-acupuncture group, psychotherapy was provided, once daily. The duration of treatment in the two groups was 8 weeks. According to the treatment times of acupuncture, the acupuncture group was subdivided into an acupuncture A group (60 cases with total treatments ≥ 6 times) and an acupuncture B group (43 cases with total treatments<6 times). Using propensity score matching method, the patients of the acupuncture A and B groups were matched each other. Finally, 31 pairs of cases were matched successfully. Before treatment, at 1st, 2nd, 4th and 8th weeks of treatment, as well as at 3-month follow-up, the scores of Hamilton depression scale (HAMD) were compared in patients among the three groups. Using Logistic regression, the impact of acupuncture frequencies on the therapeutic effect was analyzed and the clinical therapeutic effect was assessed.
Results: The total effective rate of the acupuncture A group was 100.0% (31/31), better than 76.9% (10/13) in the non-acupuncture group and 58.1% in the acupuncture B group (18/31) (P<0.05). HAMD score at each time point after treatment was lower than that before treatment in the patients of each group (P<0.05). But HAMD score at each time point after treatment in either the acupuncture A group or the acupuncture B group was lower than that in the non-acupuncture group separately (P<0.05), HAMD scores in the acupuncture A group at the 4th and 8th weeks of treatment and at follow-up were lower than those in the acupuncture B group (P<0.05). Logistic regression analysis showed that the total times of acupuncture treatment and the persistent days of treatment had a certain relation to therapeutic effect (P<0.05).
Conclusion: Acupuncture of Tiaoren Tongdu effectively improves in mild and moderate postpartum depression and its therapeutic effect is closely related to treatment course.
目的：基于真实世界观察“调任通督”法针刺治疗轻中度产后抑郁障碍的临床疗效。方法：将116例轻中度产后抑郁障碍患者根据针刺治疗情况分为针刺组（103例）和非针刺组（13例）。针刺组以“调任通督”法针刺治疗，穴取百会、印堂、中脘、气海、关元、内关、神门、合谷、足三里、三阴交、太冲，留针30 min，隔日1次，每周3次；非针刺组予心理治疗，每日1次，均治疗8周。根据针刺治疗次数，针刺组分为针刺A组（针刺治疗总次数≥6次者）60例和针刺B组（针刺治疗总次数<6次者）43例。采用倾向评分法（PS）中的最近法将针刺A组和针刺B组患者进行匹配，最终有31对病例匹配成功。比较各组患者治疗前、治疗第1周、治疗第2周、治疗第4周、治疗第8周、治疗后3个月随访时汉密尔顿抑郁量表（HAMD）评分，采用Logistic回归分析针刺治疗次数对疗效的影响，并评定临床疗效。结果：针刺A组总有效率为100.0%（31/31），优于非针刺组的76.9%（10/13）、针刺B组的58.1%（18/31，P<0.05）。各组患者治疗后各时间点HAMD评分较治疗前降低（P<0.05）；针刺A组和针刺B组患者治疗后各时间点HAMD评分低于非针刺组（P<0.05），针刺A组治疗第4、8周及随访时HAMD评分低于针刺B组（P<0.05）。Logistic回归分析得出针刺治疗总次数和治疗持续天数与疗效相关（P<0.05）。结论：“调任通督”法针刺可有效改善产后抑郁障碍，疗效与疗程密切相关。.
Keywords: Hamilton depression scale (HAMD) score; acupuncture of Tiaoren Tongdu; correlation analysis; postpartum depression; real world study.