| Purpose:(1)Through combing the ancient and modern literature of PPD,this paper summarizes the TCM knowledge of PPD and the theoretical basis of Chinese and Western medicine of acupuncture and moxibustion in the treatment of PPD;(2)To understand the morbidity of postpartum depression,discuss the important influencing factors of postpartum depression symptoms,master the risk factors and protective factors affecting postpartum depression.(3)To further clarify the clinical efficacy of “connecting and regulating Ren-Du Meridian”acupuncture in the treatment of postpartum depression,so as to provide scientific theoretical and clinical basis for the further promotion and application of “connecting and regulating Ren-Du Meridian”acupuncture.Materials and methods:(1)Under the guidance of the theory of traditional Chinese medicine,the literature related to postpartum and depression in the ancient books of traditional Chinese medicine is combed,and the theoretical basis of Chinese and Western medicine for acupuncture and moxibustion in the treatment of postpartum depression is summarized,so as to provide theoretical support for acupuncture and moxibustion in the treatment of postpartum depression.(2)From April 2018 to October 2019,baseline investigation and evaluation were conducted on pregnant women who were delivered in three hospitals,namely,Affiliated Hospital Of Liaoning University Of Traditional Chinese Medicine,The First People's Hospital Of Linkou county,Mudanjiang city and Linkou County Women's and Children's Hospital,Mudanjiang city.According to the purpose of the study,418 eligible pregnant women were screened,and the researchers collected their socio-demographic data,obstetric history and risk factors.Presumed risk factors were also collected as far as possible during the baseline survey,and risk factors that could not be collected during the baseline survey were assessed in subsequent assessments.A total of 388 cases included in the study,on the basis of EPDS 9 or higher,the screening of EPDS 9 or higher for the depression group,98 people,290 people < 9 were divided into control group,all the data using the SPSS.22 analyzed,and the estimate risk factors for single factor analysis,statistical analysis by the single factor risk factors associated with postpartum depression(P < 0.05),incorporated in the multi-factor unconditioned Logistic regression analysis model.(3)A total of 68 patients who met the diagnostic criteria for mild to moderate postpartum depression were included and randomly divided into the“connecting and regulating Ren-Du Meridian”acupuncture group(34 cases)and the control acupuncture group(34 cases).Treatments werect performed 3 times a week,4 weeks for 1 course of treatment,and 2courses of continuous treatment were performed.The patients were treated 3 times a week.Hamilton depression scale(HAMD)was recorded before treatment,1 week of treatment,2weeks of treatment,4 weeks of treatment and 8 weeks of treatment.Summary of health survey before and after treatment(SF-36).HAMD and SF-36 were used to evaluate the efficacy.At the same time,five factors of HAMD and eight dimensions of SF-36 were evaluated in order to evaluate in detail the advantages of the“connecting and regulating Ren-Du Meridian”acupuncture.Results:1.Postpartum depression has similarities and differences with depression syndrome,visceral impetuosity,Lily disease,Meihe Qi and other emotional diseases recorded in ancient literature,which is very similar to visceral impetuosity.It can be confirmed that PPD is related to visceral impetuosity.Acupuncture and moxibustion can cut in from many aspects such as clearing meridians and collaterals,balancing yin and Yang,adjusting viscera,harmonizing Qi and blood.Meanwhile,a large number of animal experiments and clinical studies have proved that acupuncture can intervene postpartum depression from the overall perspective through multiple mechanisms and multiple targets.As an effective treatment of PPD,it has a solid record of ancient books and modern theoretical basis.2.The incidence rate of postpartum depression was 25.26%(98/388)among 388 pregnant women,with an average age of 30.12±4.83 years old.The gestational weeks were38.89±1.066 weeks,168(43.30%)primary mothers,no abortion experience(46.91%),high-risk pregnant mothers were 136(35.05%),blood loss was 100~200ml 297(76.55%),cesarean section was 281(72.42%).333(85.82%)were satisfied with their relationship,162(41.75%)were mothers who took care of their babies,and 280(72.16%)were dissatisfied.There were 197 male births(50.77%),323(83.25%)babies of normal weight,and 182(46.91%)babies who were breast-fed.There were 16 women with a history of smoking(4.12%),122 women with a history of drinking(31.44%),263 women with little exercise(67.78%),and 54 women(13.92%)dissatisfied with their sleep.By the single factor analysis of the age,place of residence,birth,smoking history,postpartum sleep,confined whether satisfaction associated with recurrence(P < 0.05),incorporated in the multi-factor unconditioned Logistic regression analysis,through analysis of settlement,smoking,reproductive number,postpartum sleep is the related factors of depression,live in rural areas,has a history of smoking,first-time mothers,postpartum sleep within a higher risk of postpartum depression.3.Before treatment,there was no statistically significant difference between the two groups in the clinical data of postpartum depression patients,HAMD scale,factor scores of HAMD scale and SF-36 scale(P > 0.05),and the cases of the two groups were comparable.After treatment,the effective rate was 90% in “connecting and regulating Ren-Du Meridian”acupuncture group and 65.63% in the control group.HAMD and SF-36 were improved before and after treatment,the difference was statistically significant(P < 0.05).After treatment,the HAMD factors of “connecting and regulating Ren-Du Meridian”acupuncture group,which played a therapeutic role in anxiety / somatization,body weight,cognitive impairment,retardation and sleep disorders(P<0.05),however,the scores of anxiety / somatization,cognitive disorder,tardiness and sleep disorder decreased in the control acupuncture group(P < 0.05).There was no significant difference in the scores of body weight before and after treatment(P > 0.05).Comparison of factors between groups The effect of “connecting and regulating Ren-Du Meridian” group on cognitive impairment and retardation was better than that of control acupuncture group(P<0.05).The SF-36 scale was compared to the physiological health contents: PF,RP,BP and GH.There were no significant differences between the four groups in the overall health of the two groups(P>0.05).Comparison between the two groups after treatment.In the four dimensions of mental health,including VT,SF,RE,MH and mental health,the score of the“connecting and regulating Ren-Du Meridian” group was higher than that of the control acupuncture group(P<0.05).Conclusion:1.PPD is very similar to the symptoms of visceral dysphoria.It can be confirmed that PPD is related to visceral dysphoria,or even can be understood as one of the pathogenesis of PPD,but the two are not exactly the same.Acupuncture,as an effective treatment of PPD,has a solid record of ancient books and modern theoretical basis,.2.In this study,the incidence of postpartum depression was 25.26%.Residence,postpartum sleep,number of births,smoking history were correlated with the occurrence of postpartum depression.Residence in cities and towns,better sleep quality,and having childbearing experience were protective factors for the occurrence of postpartum depression.History of smoking was a risk factor for the occurrence of postpartum depression.3.The method of transfer to Tongdu can treat postpartum depression and improve the quality of life of postpartum depression patients. |
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