针刺联合西药对初发抑郁障碍患者血清5-HT及TH1/TH2的影响  

Impact on serum 5-HT and TH1/TH2 in patients of depressive disorder at acute stage treated with acupuncture and western medication

作　　者：刘义[1] 冯慧[2] 毛洪京[1] 莫亚莉[1] 尹岩[1] 刘文娟[1] 宋明芬[1] 王晟东[1] 

机构地区：[1]杭州市第七人民医院心理科,浙江杭州310013 [2]杭州市红十字会医院

出　　处：《中国针灸》2015年第6期539-543,共5页Chinese Acupuncture & Moxibustion

基　　金：2013年浙江省中医药科学研究基金计划项目:2013ZB107;2014年浙江省中医药科学研究基金项目:2014ZB090

摘　　要：目的：比较针刺联合选择性5-HT再摄取抑制剂（selective serotonin reuptake inhibitors,SSRIs）与单用SSRIs对初发抑郁障碍患者抑郁缓解程度疗效差异,并探讨其对血清5-羟色胺（5-HT）及TH1/TH2失衡的影响。方法：将90例初发抑郁障碍患者随机分为针药组和药物组,每组各45例。药物组口服SSRIs,1～2次/日,连续服用4周;针药组在口服SSRIs基础上联合针刺治疗,主穴取百会、印堂、神庭、风池、大椎、四神聪,隔日1次,连续治疗4周。两组于治疗前、治疗第1、2、4周末采用汉密尔顿抑郁量表（Hamilton depression scale,HAMD）评估患者抑郁程度。分别于治疗前、治疗4周后检测血清5-HT及白介素-1β（IL-1β）、白介素-6（IL-6）、白介素-4（IL-4）、白介素-10（IL-10）水平,并同45例健康人作对照。结果：针药组治疗第1、2、4周末HAMD评分较治疗前降低（均P〈0.01）;药物组治疗第2、4周末HAMD评分较治疗前降低（均P〈0.01）,针药组治疗第1、2、4周末HAMD评分较药物组低（均P〈0.01）。治疗前药物组、针药组血清5-HT及IL-4、IL-10水平均较健康组低（均P〈0.01）,IL-1β、IL-6水平较健康组高（P〈0.01）;针药组、药物组治疗4周后血清5-HT及IL-4、IL-10水平较治疗前升高（均P〈0.01）,IL-1β、IL-6水平较治疗前降低（均P〈0.01）;针药组治疗4周后血清IL-1β、IL-6水平较药物组低（均P〈0.01）,血清5-HT及IL-4、IL-10水平较药物组升高（P〈0.01,P〈0.05）。结论：针刺联合SSRIs治疗较单纯口服SSRIs可更快、更有效地缓解抑郁障碍患者抑郁程度,且更有利于调节血清5-HT及TH1/TH2的失衡。Objective To compare the difference in depression relief in the treatment of depressive disorder at the acute stage between the combined therapy of acupuncture and 5-HT（5-hydroxytryptamine）selective serotonin reuptake inhibitors（SSRIs）and the single application of SSRIs and explore the impact on the imbalance of 5-HT and TH1/TH2.Methods Ninety cases of depressive disorder at the acute stage were randomized into a combined therapy group and a medication group,45 cases in each one.In the medication group,SSRIs were prescribed for oral administration,once or twice a day,continuously for 4 weeks.In the combined therapy group,on the basis of treatment as the medication group,acupuncture was combined.The main acupoints were Baihui（GV 20）,Yintang（GV 29）,Shenting（GV 24）,Fengchi（GB 20）,Dazhui（GV 14）and Sishencong（EX-HN 1）,once every two days,continuously for 4 weeks.Before treatment,and after the 1st,2nd and 4th weeks of treatment,the Hamilton depression scale（HAMD）was used to evaluate the depression severity.Separately,before and after the4 weeks of treatment,the levels of serum 5-HT,interleukin-1 beta（IL-1β）,interleukin-6（IL-6）,interleukin-4（IL-4）and interleukin-10（IL-10）were determined and compared with those in 45 cases of the healthy group.Results HAMD score was reduced in the 1st,2nd and 4th weeks of treatment as compared with that before treatment in the combined therapy group（all P〈0.01）.HAMD score was reduced in the 2nd and 4th weeks of treatment as compared with that before treatment in the medication group（all P〈0.01）.HAMD scores in the combined therapy group were lower than those in the medication group in the 1st,2nd and 4th weeks of treatment（all P〈0.01）.Before treatment,in the combined therapy group and the medication group,the levels of serum 5-HT,IL-4 and IL-10 were all lower than those in the healthy group（all P〈0.01）;the levels of IL-1β and IL-6were higher than those in the healthy group（all P〈0.01）.In the combined thera

关 键 词：抑郁障碍 初发 针刺 5-HT再摄取抑制剂 炎性细胞因子 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]