通关利窍针刺法联合丁螺环酮片治疗复发性抑郁障碍伴轻度认知障碍疗效观察  

Efficacy Observation of Tong Guan Li Qiao Acupuncture Method Combined with Buspirone Tablets for Recurrent Depressive Disorder Coupled with Mild Cognitive Impairment

作　　者：唐颖[1] 张素娟[1] 赵蕊[1] 崔璐莎 刘欣 王亚楠 TANG Ying;ZHANG Su-juan;ZHAO Rui;CUI Lu-sha;LIU Xin;WANG Ya-nan(Kailuan Mental Health Center,Tangshan 063001,China)

机构地区：[1]开滦精神卫生中心,唐山063001

出　　处：《上海针灸杂志》2021年第1期26-31,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省2019医学科学研究课题(20191324)。

摘　　要：目的观察通关利窍针刺法联合丁螺环酮片治疗复发性抑郁障碍伴轻度认知障碍(MCI)的临床疗效。方法选择120例复发性抑郁障碍伴MCI患者作为研究对象,按照入院顺序进行编号,通过随机数字表法分为观察组和对照组,每组60例。对照组给予常规抗抑郁药物和丁螺环酮片治疗,观察组在此基础上给予通关利窍针刺法。比较两组治疗前后蒙特利尔认知评估量表(MoCA)、汉密尔顿抑郁量表17项(HAMD-17)、个体和社会功能量表中文版(PSP-CHN)评分和中医证候积分变化,比较两组治疗前后血清脑源神经营养因子(BDNF)、神经生长因子(NGF)、神经营养因子-3(NT-3)及血清铁蛋白(SF)水平,并比较两组临床疗效。结果治疗后观察组HAMD-17评分、中医证候积分低于对照组(P<0.05),MoCA评分、PSP-CHN评分高于对照组(P<0.05);治疗后观察组血清BDNF、NGF、NT-3水平高于对照组(P<0.05),SF低于对照组(P<0.05);观察组总有效率为88.4%,显著高于对照组71.7%(P<0.05);观察组复发率为8.3%,显著低于对照组的21.7%(P<0.05)。结论通关利窍针刺法联合丁螺环酮片能够显著缓解复发性抑郁障碍伴MCI患者临床症状,改善认知功能和社会功能,提高临床治疗效果,降低复发率,可能与上调BDNF、NGF、NT-3,下调SF水平有关。Objective To observe the clinical efficacy of Tong Guan Li Qiao(unblocking gates and orifices) acupuncture method plus Buspirone tablets in treating recurrent depressive disorder coupled with mild cognitive impairment(MCI).Method A total of 120 patients with recurrent depressive disorder coupled with MCI were recruited as the subjects.They were coded according to their admission sequence and allocated to an observation group and a control group by the random number table method,with 60 cases in each group.The control group was given conventional antidepressant and Buspirone tablets for treatment,while the observation group was given additional Tong Guan Li Qiao acupuncture.The scores of Montreal Cognitive Assessment(MoCA),Hamilton Depression Rating Scale-17(HAMD-17),Chinese version of Personal and Social Performance Scale(PSP-CHN)and symptom score of traditional Chinese medicine(TCM)were compared after treatment between the two groups,as well as the levels of serum brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),neurotrophin-3(NT-3)and serum ferritin(SF).The clinical efficacy was also compared.Result After treatment,the HAMD-17 and TCM symptom score were lower in the observation group than in the control group(P<0.05)and the MoCA and PSP-CHN scores were higher in the observation group than in the control group(P<0.05);the level of serum BCNF,NGF,NT-3 were higher(P<0.05)and the level of SF was lower(P<0.05)in the observation group than in the control group after treatment.The clinical total effective rate was 88.4%in the observation group,significantly higher than 71.7%in the control group(P<0.05);the relapse rate was 8.3%in the observation group,significantly lower than 21.7%in the control group(P<0.05).Conclusion Tong Guan Li Qiao acupuncture method plus Buspirone tablets can notably mitigate the clinical symptoms in patients with recurrent depressive disorder coupled with MCI,manifesting as the improvement of the cognitive function and social function,enhanced clinical efficacy and lower relaps

关 键 词：针刺疗法 针药并用 认知训练 抑郁症 认知障碍 神经营养因子 血清铁蛋白 

分 类 号：R246.6[医药卫生—针灸推拿学]