磁珠耳穴贴压联合重复经颅磁刺激对脑卒中后抑郁的疗效  

Therapeutic effects of auricular points sticking with magnetic beads combined with repeated transcranial magnetic stimulation on post-stroke depression

作　　者：赵璇 李晓鹏 李剑 田彬 王广君[1] ZHAO Xuan;LI Xiaopeng;LI Jian;TIAN Bin;WANG Guangjun(Department of Neurology,Dongying Shengli Hospital,Dongying 257000,Shandong,China;Department of Physiotherapy,Shengli Oilfield Central Hospital,Dongying 257000,Shandong,China)

机构地区：[1]东营市胜利医院神经内科,山东东营257000 [2]胜利油田中心医院理疗科,山东东营257000

出　　处：《山东大学学报（医学版）》2022年第1期65-70,共6页Journal of Shandong University:Health Sciences

基　　金：2020年中国石化集团胜利石油管理局科技攻关项目(GKY2002)

摘　　要：目的探讨磁珠耳穴贴压联合重复经颅磁刺激(rTMS)治疗脑卒中后抑郁患者的效果以及对血清中的瞬时受体电位通道1蛋白(TRPC1)、5-羟色胺(5-HT)、S100β蛋白水平的影响。方法选取脑卒中后抑郁的患者120例,采用随机数字表分为对照组(抗抑郁药物治疗)、rTMS组(抗抑郁药物+rTMS治疗)、耳穴组(抗抑郁药物+磁珠耳穴贴压治疗)、rTMS+耳穴组(抗抑郁药物+rTMS+磁珠耳穴贴压治疗)各30例,治疗疗程为4周;对比4组治疗前后的汉密尔顿抑郁量表(HAMD)评分、临床疗效和血清TRPC1、5-HT、S100β水平变化及不良反应。结果治疗前,对照组、rTMS组、耳穴组及rTMS+耳穴组的HAMD评分,差异无统计学意义(P>0.05);治疗后,rTMS+耳穴组的HAMD评分低于对照组、rTMS组及耳穴组(P<0.05);rTMS组、耳穴组的HAMD评分低于对照组(P<0.05);治疗前,对照组、rTMS组、耳穴组及rTMS+耳穴组的血清TRPC1、5-HT、S100β水平差异无统计学意义(P>0.05);治疗后,rTMS+耳穴组患者的血清S100β水平低于对照组、rTMS组及耳穴组(P<0.05),TRPC1、5-HT水平高于对照组、rTMS组、耳穴组(P<0.05);治疗后,rTMS组、耳穴组的血清S100β水平低于对照组(P<0.05),TRPC1、5-HT水平高于对照组(P<0.05);经过治疗,rTMS+耳穴组患者的总有效率高于对照组、rTMS组、耳穴组(P<0.05),rTMS组、耳穴组的总有效率明显高于对照组(P<0.05)。结论磁珠耳穴贴压联合rTMS治疗对于脑卒中后抑郁患者有着肯定的疗效,能有效调节血清TRPC1、5-HT及S100β水平,明显改善患者的抑郁症状。Objective To investigate the effects of auricular points sticking with magnetic beads combined with repeated transcranial magnetic stimulation(rTMS)on post-stroke depression patients and the effects on the levels of serum transient receptor potential channel 1 protein(TRPC1),serotonin(5-HT),and S100β protein.Methods A total of 120 patients with post-stroke depression were selected and randomly divided into the control group(antidepressant treatment),rTMS group(antidepressant+rTMS),auricular points group(antidepressant+auricular points sticking with magnetic beads treatment),and rTMS+auricular points group(antidepressants+rTMS+auricular points sticking with magnetic beads treatment),with 30 cases in each group and treatment course of 4 weeks.The Hamilton Depression Scale(HAMD)score,clinical efficacy,changes of TRPC1,5-HT and S100β,and adverse reactions in the four groups were compared.Results Before treatment,there was no significant difference in the HAMD score among the four groups(P>0.05).After treatment,the HAMD score was lower in the rTMS+auricular point group than in other three groups(P<0.05),and the HAMD score in the rTMS and auricular points groups was lower than that in the control group(P<0.05).Before treatment,there were no significant differences in the levels of TRPC1,5-HT and S100β among the four groups(P>0.05).After treatment,the level of S100βin the rTMS+auricular points group was lower than that in other three groups(P<0.05).The levels of TRPC1 and 5-HT in the rTMS+auricular points group were higher than those in the other three groups(P<0.05).The level of S100βin the rTMS and auricular points groups was lower than that in the control group(P<0.05),and the levels of TRPC1 and 5-HT were higher than in the control group(P<0.05).The total effective rate of the rTMS+auricular points group was higher than that of the other three groups(P<0.05).The total effective rate of the rTMS and auricular points groups was higher than that of the control group(P<0.05).Conclusion Auricular points sticking wit

关 键 词：重复经颅磁刺激 磁珠耳穴贴压 脑卒中后抑郁 瞬时受体电位通道1蛋白 5-羟色胺 S100Β蛋白 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R743.3[医药卫生—临床医学]