关键词:

产后抑郁, 母婴分离, 帕罗西汀, 双歧杆菌四联活菌片, 肠道菌群, 神经内分泌功能

Abstract:

Objective　To explore the effect of probiotics combined with paroxetine on intestinal flora in patients with postpartum depression caused by mother-infant separation. Methods　A total of 106 patients who gave birth in Xi'an Daxing Hospital from May 2020 to May 2023 and were diagnosed as postpartum depression caused by mother-infant separation were divided into two groups according to treatment methods, with 53 cases in each group. In the control group, 25 primiparas and 28 multiparas, aged (28.21±3.17) years, were given oral paroxetine tablets, 20 mg/time, once a day. In the observation group, 30 primiparas and 23 multiparas, aged (27.55±3.12) years, were treated with probiotics (oral Bifidobacterium tetrad tablets, 3 tablets/time, 3 times/day) combined with paroxetine. Both groups were treated continuously for 6 weeks. The clinical efficacy, inflammatory factors, neuroendocrine, intestinal flora level, quality of life, and medication safety were compared between the two groups. χ² test, t test, and rank sum test were used. Results　In the observation group, the cure rate, significantly effective rate, effective rate, and ineffective rate were 54.72% (29/53), 24.53% (13/53), 16.98% (9/53), and 3.77% (2/53), respectively. In the control group, the cure rate, significantly effective rate, effective rate, and ineffective rate were 37.74% (20/53), 22.64% (12/53), 22.64% (12/53), and 16.98% (9/53), respectively. The curative effect of the observation group was better than that of the control group (Z=2.274, P=0.023). Six weeks after treatment, the levels of interleukin-1β, malondialdehyde, and CC chemokine ligand 2 in the observation group were lower than those in the control group [(4.63±1.54) ng/L vs. (5.58±1.86) ng/L, (2.95±0.51) mmol/L vs. (3.24±0.54) mmol/L, (431.63±72.27) ng/L vs. (483.41±80.56) ng/L], the levels of superoxide dismutase, 5-hydroxytryptamine, dopamine, and neuropeptide Y were higher than those in the control group [(124.51±13.84) U/L vs. (112.69±12.52) U/L, (194.33±14.95) µg/L vs. (185.64±14.28) µg/L, (3.94±0.61) µmol/L vs. (3.65±0.57) µmol/L, (15.28±2.21) mg/L vs. (13.47±2.07) mg/L], the levels of Lactobacillus and Bifidobacterium were higher than those in the control group [(9.52±0.73) log N/g vs. (8.11±0.76) log N/g, (9.23±0.84) log N/g vs. (7.96±0.72) log N/g], with statistically significant differences (all P<0.05). The Pittsburgh Sleep Quality Index of the observation group was lower than that of the control group [(5.21±1.03) points vs. (5.84±1.16) points], and the SF-36 score was higher than that of the control group [(83.25±6.41) points vs. (78.49±6.04) points] (both P<0.05). Conclusion　Probiotics combined with paroxetine in the treatment of postpartum depression caused by mother-infant separation can effectively improve the efficacy and quality of life by reducing the level of inflammation, promoting the improvement of neuroendocrine function, and improving the intestinal flora, and the medication is relatively safe.

Key words:

Postpartum depression, Mother-infant separation, Paroxetine, Bifidobacterium tetrad tablets, Intestinal flora, Neuroendocrine function