中医情志疗法对寻常型银屑病患者HAMD、HAMA水平及外周血单胺类神经递质的影响  

Impact of TCM Psychotherapy on Psoriatic Vulgaris Patients about HAMD/HAMA Score and Serum Monoamine Neurotransmitter Levels

作　　者：郑益志[1,2] 陈春凤[1] 贾丽莹[1] 余土根[1] 曹毅[1] 

机构地区：[1]浙江中医药大学附属第一医院,杭州310006 [2]浙江中医药大学

出　　处：《浙江中医药大学学报》2013年第5期506-510,共5页Journal of Zhejiang Chinese Medical University

基　　金：浙江省自然基金资助项目(Y2100759);浙江省中医药科技项目(2011ZB046)~~

摘　　要：[目的]观察中医情志疗法治疗寻常型银屑病患者的临床疗效,通过检测治疗前后患者汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)水平及血清单胺类神经递质表达水平的变化,探讨中医情志疗法治疗寻常型银屑病的可能机理。[方法]将符合诊断标准的60例进展期寻常型银屑病患者按照1:1随机分成两组。对照组口服复方甘草酸苷片(美能)每次50mg,3次/d;外用卤米松/三氯生乳膏(新适确得)、卡泊三醇软膏(达力士),涂擦于患处,各2次/d。治疗组在对照组西医治疗基础上配合中医情志疗法进行治疗,4周为1疗程,观察两组疗效。治疗前后分别对两组进行HAMD和HAMA评分,并采用高效液相色谱-荧光检测法测定血清中去甲肾上腺素(NE)、多巴胺(DA)及5-羟色胺(5-HT)等单胺类神经递质的含量,另取健康志愿者30例作为健康对照组。[结果]治疗组临床疗效优于对照组,总有效率分别为93.33%和66.67%,具有统计学差异(P<0.01)。两组患者治疗前HAMD、HAMA评分及血清单胺类神经递质的水平明显高于健康对照组,有显著性差异(均P<0.01)。治疗后HAMD、HAMA评分及血清单胺类神经递质的水平均有不同程度的下降,与治疗前相比均有显著统计学意义(P<0.05或P<0.01),但治疗组下降更显著,与对照组比较有显著性差异(P<0.01)。[结论]银屑病患者存在明显的抑郁、焦虑情绪障碍,中医情志疗法能有效改善银屑病患者的临床症状及精神状态,其作用机制可能与降低外周血单胺类神经递质有关。[Objective] To observe the clinical efficacy of the TCM psychotherapy and the changes of serum monoamine neurotransmitter levels and HAMD/HAMA score in psoriatic patients after treatment,so as to discuss its function mechanism.[Methods] Clinical evaluations were made on 60 patients suffering from psoriasis.They were randomly divided into two groups in the proportion of 1 to 1.The control group cases were given conventional therapy,on the basis of which,the treatment group cases were treated with TCM psychotherapy,four weeks as a period.Then observed HAMD/HAMA score and the serum monoamine neurotransmitter levels（NE,DA,5-HT） in psoriatic patients were measured with high performance liquid chromatography,and compared the results before and after treatment.Put another 30 cases of healthy volunteers as normal control group.[Results] The clinical efficacy of treatment group was significantly higher than control group,the total effective rates were 93.33% and 66.67% respectively.Before treatment,the serum monoamine neurotransmitter levels and HAMD/HAMA score in psoriatic patients were higher than the healthy control group.The serum monoamine neurotransmitter levels and HAMD/HAMA score of both groups were significantly reduced after the treatment,but the changes in the treatment group were better than those of the control group.[Conclusion] TCM psychotherapy can lower the serum monoamine neurotransmitter levels and HAMD/HAMA score,so as to improve the clinical symptoms of psoriatic patients.

关 键 词：银屑病 中医情志疗法 HAMD HAMA NE DA 5-HT 

分 类 号：R331[医药卫生—人体生理学]