국내 산후 우울증의 한의학적 치료 임상 보고에 대한 고찰

Abstract

Objectives To systematically analyze the therapeutic patterns, clinical effectiveness, and scientific mechanisms of Korean Traditional Medicine (TKM) interventions for Postpartum Depression (PPD) based on domestic clinical case reports. The findings aim to provide foundational data for the future development of standardized clinical practice guidelines (CPG). Methods Nine clinical case reports regarding TKM treatment for PPD, published between 2001 and 2012, were retrieved from the Science On and OASIS databases using terms including ‘산후 우울증’ and ‘postpartum depression.’ Only clinical case reports (eight with N=1, one with N=2) applying TKM were included, while systematic reviews and meta-analyses were excluded. The low level of evidence (Level V) inherent in case reports represents a primary limitation of the analyzed data. Result All nine studies utilized Herbal Medicine (HM), frequently combining it with Acupuncture (AC) (6 studies) and Western Medicine (WM) (6 studies), reflecting a multidisciplinary clinical approach. The most frequently used herbs were Ginseng (人蔘, 12 times), Angelica gigas (當歸, 11 times), and Atractylodes macrocephala (白朮, 10 times), primarily targeting Qi-Blood Deficiency (氣血虛弱) and Qi Stagnation (氣鬱). The most common acupoints utilized were PC6 (內關, Neiguan) and HT7 (神門, Shenmen). All reports indicated positive therapeutic outcomes, showing a significant reduction in EPDS scores (e.g., from 25 to 12) and improvements in associated somatic symptoms, including insomnia, pain, and fatigue. One study objectively demonstrated the normalization of TSH levels (from 0.08 to 2.29) following TKM intervention. Conclusion TKM interventions demonstrated favorable clinical efficacy in alleviating PPD and associated symptoms by addressing the underlying TKM pathologies of Heo (Deficiency) and Ul (Stagnation). High-quality randomized controlled trials are urgently needed to establish standardized CPGs and validate the mechanism of TKM in regulating the Hypothalamic–Pituitary–Adrenal axis and neuroinflammation.