产后抑郁症的中医证型和方药规律
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中国中医科学院基本科研业务费自主选题项目(ZZ070845)


Literature Study on Syndrome,Formula and Medicine Choice of Postpartum Depression
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    摘要:

    目的:探求产后抑郁症(Postpartum Depression,PPD)的证型和临床用药规律。方法:通过对1996年1月至2016年8月中国期刊全文数据库收录的中医治疗PPD的临床研究,对文献中的证型、方剂以及药物出现频次和比例进行统计归类,对药物和症状进行聚类分析。结果:通过整理分析得出21个PPD证型,其中心脾两虚、肝气郁结、气虚血瘀、脾肾两虚、痰热郁结为常见证型;证型要素分析,肝郁、血瘀、气滞、痰湿、痰瘀为常见实性证型;心脾两虚、气虚、血虚、脾肾两虚、阴虚、气血两虚、肾虚为常见虚性证型;病位主要在心、肝、脾、肾四脏;共得方剂108首,其中自拟方59首,成方49首,两者以补益剂、理气剂、理血剂为主;整理中药139味,分为9类,柴胡、当归、党参、白芍等为常用药。结论:PPD的证型、选方和用药具有不同于其他时期抑郁症的特点,强调以疏肝理气、产后补虚为法,兼以注重对血的调养,同时注重对PPD患者心身的共同调整。

    Abstract:

    To study the syndrome and rule of medicine choice in postpartum depression (PPD) according to analysis of the traditional Chinese medicine theory and clinical research.Methods:The domestic literatures of Traditional Chinese Medicine for the treatment of PPD from January 1996 to April 2016 are searched and collected through CNKI database to analyze the treatment rule.Syndrome,prescription and herbs are classified and counted the frequency and proportion for cluster analysis.Results:PPD has 21 syndromes,in which deficiency of heart and spleen,stagnation of liver qi,deficiency of qi and stagnation of blood,deficiency of spleen and kidney and syndrome of binding phlegm-heat and qi are more common.Stagnation of liver,blood stasis,qi stagnation,phlegm and stasis are excess syndromes.Deficiency of heart and spleen,deficiency of qi,deficiency of blood,deficiency of spleen and kidney,deficiency of Yin,deficiency of qi and blood and deficiency of kidney are deficiency syndromes.The locations of the disease are liver,kidney,spleen and heart.The mainly used prescriptions are tonic prescriptions,energy-regulating prescriptions and blood-regulating prescriptions.Radix Bupleuri,Angelica sinensis,Codonopsis pilosula and Rasix paeoniae alba are common used herbs.Conclusion:The syndrome,prescription and medicine choice are different from other periods,which emphasizes soothing-liver,regulating qi,tonifying deficiency in postpartum and pays attention to recuperate blood.Meanwhile,mentality and fitness should be treat together.

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许琳洁,郑瑀,施蕾,许凤全.产后抑郁症的中医证型和方药规律[J].世界中医药,2017,(07).

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  • 收稿日期:2016-11-28
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  • 在线发布日期: 2017-07-24
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