针刺对卒中后抑郁患者tPA/BDNF通路相关神经调节因子的影响  

Effect of Acupuncture on Related Neuroregulatory Factors of tPA/BDNF Pathway in Patients with Post-stroke Depression

作　　者：章显宝[1] 王震[1] 郑之俊[1] 梁发俊[1] ZHANG Xian-bao;WANG Zhen;ZHENG Zhi-jun;LIANG Fa-jun(Department of Encephalopathy, Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230000, China)

机构地区：[1]安徽中医药大学第二附属医院脑病六科,合肥230000

出　　处：《科学技术与工程》2021年第15期6230-6235,共6页Science Technology and Engineering

基　　金：安徽省科技厅面上科技攻关项目(1704a0802169);国家自然科学基金面上项目(81273857)。

摘　　要：为观察针刺对卒中后抑郁(post-stroke depression,PSD)患者组织纤溶酶激活因子(tPA)/脑源性神经营养因子(BDNF)通路相关神经调节因子的影响。随机选取40例PSD患者分为对照组和研究组,对照组采用度洛西汀胶囊口服治疗,服用方法一日1次,每次1片。研究组在度洛西汀胶囊口服治疗基础上予针刺治疗。疗程均为14 d。观察治疗前后临床疗效,汉密尔顿抑郁量表(HAMD)积分、美国国立卫生研究院卒中量表(NIHSS)积分变化。采用ELISA法检测患者血清tPA、纤溶酶原激活物抑制剂-1(PAI-1)、BDNF、酪氨酸激酶受体B(TrkB)蛋白表达。qPCR检测外周血tPA、PAI-1、BDNF、TrkB mRNA表达。结果表明:针药组总有效率高于对照组(P<0.05)。与治疗前比较,对照组、针药组治疗后HAMD、NIHSS评分降低(P<0.05或P<0.01)。与对照组治疗后比较,针药组治疗后HAMD评分降低(P<0.01)。与治疗前比较,对照组、针药组治疗后BDNF、TrkB、tPA、PAI-1表达升高,BDNF、TrkB、tPA、PAI-1 mRNA升高(P<0.01)。与对照组比较,针药组治疗后BDNF、TrkB、tPA、PAI-1表达升高,BDNF、TrkB、tPA、PAI-1 mRNA表达升高(P<0.05或P<0.01)。可见针刺可以调节tPA/BDNF通路相关神经因子表达,改善PSD患者神经功能。In order to observe the effect of acupuncture on related neuromodulator of tissue plasmin activating factor(tPA)/brain-derived neurotrophic factor(BDNF)pathway in patients with post-stroke depression(PSD).40 patients with PSD were randomly selected and divided into a control group and a research group.The control group was treated orally with paroxetine tablets.The method was taken once a day,1 tablet each time.The research group was received acupuncture treatment based on duluoxetine tablets.The course was treated for 14 days.The clinical efficacy was observed before treatment and after treatment and the hamilton depression scale(HAMD)score and national institutes of health stroke scale(NIHSS)score before treatment as well as after treatment were observed.Serum tPA,plasminogen activator inhibitor-1(PAI-1),BDNF,tyrosine kinase receptor B(TrkB)were detected by ELISA.qPCR was used to detect the expression of peripheral blood tPA,PAI-1,BDNF,and TrkB mRNA.The results show that the total effective rate in the acupuncture and medicine group was significantly higher than that of the control group(P<0.05).Compared with before treatment,the HAMD and NIHSS scores of the control group and the acupuncture group was significantly decreased after treatment(P<0.05 or P<0.01).Compared with the control group after treatment,the HAMD score was significantly decreased after treatment in the acupuncture group(P<0.01).Compared with before treatment,the expressions of BDNF,TrkB,tPA and PAI-1 was significantly increased,and the expressions of BDNF,TrkB,tPA and PAI-1 mRNA was significantly increased(P<0.01).Compared with the control group,the expression of BDNF,TrkB,tPA,and PAI-1 increased,and the expression of BDNF,TrkB,tPA,and PAI-1 mRNA was significantly increased(P<0.05 or P<0.01).It is concluded that acupuncture can regulate the tPA/BDNF pathway and the expression of related nerve factors,and improve the nerve function of patients with PSD.

关 键 词：卒中后抑郁 组织纤溶酶激活因子 脑源性神经营养因子 针刺 

分 类 号：R245[医药卫生—针灸推拿学]