| ObjectiveThis study is based on the clinical fact that there are differences in the efficacy of acupuncture antidepressants,and the impact of the intestinal flora on the occurrence,development and efficacy of patients with mild to moderate postpartum depression as the starting point to explore whether the differences in the efficacy of acupuncture antidepressants are Related to the structural differences of individual intestinal flora,studying the mechanism of acupuncture treatment of individual differences is of great significance for the screening of clinical cases and the prediction of curative effect.MethodsThis study is a prospective cohort study.According to the inclusion and exclusion criteria,patients with postpartum depression(PPD)who meet the requirements were included.The exposure factor was whether to accept acupuncture intervention.Among them,the acupuncture group was the acupuncture group,and the acupuncture treatment was not accepted.Of the patients were the control group.The acupuncture program of the acupuncture group adopts the "transfer of appointment and supervision" acupuncture method,3 times a week for a total of 8 weeks of treatment.The two groups of patients were evaluated on the Hamilton(HAMD)scale and collected stool samples during the baseline period and 8 weeks after enrollment.The HAMD score reduction rate was used to evaluate whether the treatment was effective,and the subjects were divided into treatment effective group and treatment ineffective group.The intestinal flora analysis of stool samples uses 16SRNA analysis.The difference of intestinal flora between the effective group and the ineffective group of acupuncture treatment was compared and analyzed.Results1.Completion of the number of patient cases:A total of 105 subjects were enrolled in this study,and 71 patients received acupuncture treatment,of which 54 patients completed HAMD visits before and after treatment;34 patients in the control group,all completed HAMD visits before and after treatment.An analysis of the clinical efficacy of the transfer-to-registration acupuncture method for mild to moderate postpartum depression.The results show that the hamd reduction rate before and after treatment is calculated according to the efficacy evaluation criteria.Among them,35 cases are more than 50%.This is the patient who is effective in treatment,and the other 19 cases are For patients with ineffective treatment,acupuncture is effective in treating PPD,and the effective rate is 64.81%.2.The analysis of the flora result shows:(1)The results of the four diversity indexes of the two groups before treatment showed that there was no significant difference in α and β diversity between the two groups,no significant difference in flora structure,and no significant difference in the species abundance of the sample flora.The analysis of LEfSe dominant bacteria showed no significant difference between the two groups.(2)The results of the four diversity indexes of the two groups after treatment showed that there was no significant difference in the alpha diversity and beta diversity between the two groups.After treatment,there is a difference between the phylum level composition of the top 5 abundance and the top 15 genera in the intestinal flora after treatment.The treatment response group(group A)is enriched,including bifidobacteria,rumen cocci,clostridia,etc.Most of them are beneficial bacteria;the non-response group(N group)is enriched,including Pasteurella,Haemophilus,Macrococcus,etc.,and most of them are common harmful bacteria.Conclusion1.The transfer of acupuncture method to treat PPD is effective as a whole,and there are individual differences in the efficacy of acupuncture in the treatment of PPD patients.2.The antidepressant effect of acupuncture may be related to the regulation of the intestinal flora of patients with PPD and the increase of the abundance of probiotics in the flora,while the ineffectiveness of acupuncture may be related to the enrichment of harmful bacteria in the flora of such patients related. |
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