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1、达到治疗抑郁症的作用关键词 灸法 松弛疗法 抑郁症 五羟色胺2Research on Influence of Moxibustion at Baihui, DanzhongPoints and Relaxing Therapy on Concentration of Major DepressiveDisorderAbstractObjectivesBy observing the influence of moxibustion at Baihui, Danzhong Points and Relaxingtherapy on concentration of Major Depressi
2、ve Disorder (5-HT for its value), Im tostudy the influence and that of taking fluoxetine by comparasion. Meanwhile, its to doresearch on the function principle and that of taking fluoxetine by comparasion .Mealwhile, its to do research on the function principles of Baihui,Danzhong Pointsand Relaxing
3、 therapy for treating Major Depressive Disorder,as well as provide a safeand effective clinical treatment so as to broaden our horizon on treating MajorDepressive Disorder.MethodsThe collected cases were accorded with standards for diagnosing Major DepressiveDisorder in CCMD-3 and those with scores
4、larger than 20 in HAMD. There were 60cases accorded with standards in the sixth edition of “Chinses Medicine”. They weredivided into two groups randomly according to when they received the treatment.Thetreated group received moxibustion at Baihui and Danzhong points and relaxingtherapy, and another
5、group named comparative group received western medicine,fluoxetine. Each period of treatment lasted for 8 weeks. Before and after the casesreceived the respective treatment, HAMD values and 5-HT concentration in serumwere examined. The high effective liquid chromatography and electrochemical process
6、were utilized in the latter examination. By comparing the HAMD values and 5-HTconcentration in serum before treatment to those after treatment and analyzing theclinical data, we can gain clinical datas and know the treatment effect of moxibustionand relaxing therapy on Major Depressive Disorder and
7、offer a new safe clinicalmethod for the Major Depressive Disorder.3Results1. Moxibustion therapy and relaxing therapy can influence the 5-HT concentration inserum of Major Depressive Disorder patients significantly, that is, they can increase 5-HT concentration in serum.2. Moxibustion therapy and re
8、laxing therapy can improve considerably the HAMDvalues of Major Depressive Disorder patients, and its effect is equal to that of the purewestern medicines.3. There is no significant difference in the 5-HT concentration in serum of MajorDepressive Disorder patients after respective treatment between
9、the treated group andthe comparative group.4. Moxibustion therapy and relaxing therapy can improve the clinical symptomobviously and the effect is are better than that of the pure treatment of westernmedicines.ConclusionsMoxibustion at Baihui and Danzhong points and relaxing therapy cansignificantly
10、 increase the 5-HT concentration in serum of Major Depressive Disorderpatients. Moxibustion at Baihui and Danzhong points can raise Yang Quality, regulatefunctional activities of vital energy and eliminate stagnation. At the same time, relaxingtherapy as a assistant way may also regulate functional
11、activities of vital energy, slowdown the cardiac rhythm and respiratory rhythm, drop blood pressure, as well as bringvital energy into relaxation, and alleviate the ill emotion caused by Major DepressiveDisorder. Our research sufficiently testified that the combination of the traditionalChinese acup
12、uncture methods with the modern relaxing therapy can cure the MajorDepressive Disorder very well. The treatment principle may be like this: the central 5-HT nerve cells are activated somehow by acupuncture and relaxing therapy, and thenthe secrets 5-HT are increased, which is responsible for curing
13、dysthymia finally.Key words moxibustion therapy, relaxing therapy, Major Depressive Disorder,serotonin4前 言抑郁症 Major Depressive Disorder 是一种以显著而持久的心境或情感改变为主的情感性精神障碍 常伴有情绪低落 躯体不适 睡眠障碍等症状 随着社会竞争的日益激烈 生活和工作压力的不断增加 本病的发病率呈逐年上升趋势 因此抑郁症也越来越受到重视 各领域的人们都在试图用自己专业的知识去探讨和治疗抑郁症20 世纪 80 年代以来 国内外的专业工作者对抑郁症的流行病学 病因
14、学发病机制及临床表现 诊断治疗等多方面进行研究 尤其在发病机制和治疗方面做了较多的研究 神经生化机制认为抑郁症是脑内单胺递质如去甲肾上腺素五羟色胺和多巴胺的功能不足所致 神经内分泌机制主要集中在下丘脑 垂体 肾上腺轴 HPA 和下丘脑 垂体 甲状腺轴 HPT 两方面 认为抑郁症病人血浆皮质醇含量高 尿皮质醇及代谢物排除也高 脑脊液中促肾上腺皮质激素释放激素浓度增高 提示抑郁症病人 HPA 轴功能障碍 免疫机制揭示抑郁症的免疫功能改变可能是其病因或抑郁症所致的结果 抑郁症患者功能呈抑制性改变 表现为病人淋巴总数下降 T B 淋巴细胞增殖抑制等 脑功能影像学发现双相情感障碍两侧前额叶皮质不对称 额
15、叶功能低下及全皮质葡萄糖代谢低下,左额叶局部脑血流量降低 降低程度与抑郁的程度呈正相关 在治疗方面有大量的精神药物 如三环类及四环类抗抑郁药 米帕明 阿米替林麦普替林等 单胺氧化酶抑制剂 吗氯贝胺等 选择性五羟色胺再摄取抑制剂 氟西汀 帕罗西汀 舍曲林等 5-HT 和 NE 再摄取抑制剂 盐酸文拉法辛 等 此外还有心理治疗 包括人际心理治疗 婚姻家庭治疗 行为治疗和认知治疗等 心理治疗和药物治疗相结合可提高抑郁症的缓解率 减少复发抑郁症属于中医 郁证 的范畴 中医认为其病因病机主要是由于情志不舒 气机不畅及阳气不振所致气 血 痰 食 湿郁滞的病证 因此在治疗上主要采取中药 针灸 推拿等治疗方法
16、 均取得一定的疗效 艾灸法是中医的一种独特疗法 其在临床应用范围不断扩大 国内外学者借助现代方法和技术手段对传统艾灸进行了探讨和研究 取得很大的进展 通过临床观察,灸百会和膻中可以开窍醒神 疏肝解郁 振奋人体阳气 对抑郁症的治疗效果显著 松弛疗法是现代心理学中的一种行为治疗方法5具有很好的抗应激效果 可使全身骨骼肌张力下降 呼吸和心率减慢 血压下降 从而对人体的生理 心理和神经系统都有一定的调节作用 本课题采用灸百会和膻中配合松弛疗法治疗抑郁症 意在将传统的中医疗法和现代心理疗法相结合 挖掘出一种治疗抑郁症的新方法 以期望能够缩短抑郁症疗程 稳定病情 控制复发 减少口服西药所带来的副作用 减轻抑郁症患者的经济负担 同时也对灸法和松弛疗法治疗抑郁症的机制进行初步探讨 便于今后在临床中推广6第一部分 文献研究1 流行病学调查关于抑郁症的发病率已有大量的研究报道 美国国立卫生院在其建立的流行病调查地区进行的调查发现 抑郁症的终生患病率为 4.9%1 WHO 的一项以15 个城市为中心的全球性合作研究 调查综合医院就诊中的心理障碍
