多塞平联合艾司西酞普兰对抑郁症患者胶质细胞源性神经营养因子、5-羟色胺水平的影响  

Effects of Doxepin Combined with Escitalopram on Levels of Glial Cell-Derived Neurotrophic Factor and 5-Hydroxytryptamine in Patients with Depression

作　　者：张秀琼 林荫[2] 梁永清 陈盛柏 ZHANG Xiuqiong;LIN Yin;LIANG Yongqing;CHEN Shengbai(Dept.of Mental Rehabilitation,Hainan Provincial Anning Hospital,Hainan Haikou 570100,China;Psychological Consultation and Treatment Center,Hainan Provincial Anning Hospital,Hainan Haikou 570100,China;Dept.of Material Dependence,Hainan Provincial Anning Hospital,Hainan Haikou 570100,China;Dept.of Psychiatry,Hainan Pingshan Hospital,Hainan Wuzhishan 572200,China)

机构地区：[1]海南省安宁医院精神康复科,海南海口570100 [2]海南省安宁医院心理咨询与治疗中心,海南海口570100 [3]海南省安宁医院物质依赖科,海南海口570100 [4]海南省平山医院精神科,海南五指山572200

出　　处：《中国医院用药评价与分析》2021年第11期1344-1347,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：海南省卫生健康行业科研项目(No.20A200411)。

摘　　要：目的:探讨多塞平联合艾司西酞普兰对抑郁症患者胶质细胞源性神经营养因子(GDNF)、5-羟色胺(5-HT)水平的影响。方法:选取2017年8月至2019年8月于海南省安宁医院接受治疗的抑郁症患者123例,按照随机数字表法分为西酞普兰组61例、联合治疗组62例。西酞普兰组患者采用艾司西酞普兰治疗,联合治疗组患者采用多塞平联合艾司西酞普兰治疗。采用汉密尔顿抑郁量表(hamilton depression scale,HAMD)评价患者心理抑郁情况,采用匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评价患者睡眠质量,采用成人自杀意念问卷(adult suicidal Ideation questionnaire,ASIQ)对患者自杀意念进行评价。采用免疫透射比浊法检测患者GDNF、5-HT水平,采用酶标分析仪检测白细胞介素(IL)2、IL-22、IL-1β、总抗氧化能力(TAOC)、8-羟基脱氧鸟苷(8-OHdG)和过氧化氢酶(CAT)水平,采用流式细胞仪检测T淋巴细胞亚群水平。观察两组患者的治疗效果。结果:治疗后,与西酞普兰组比较,联合治疗组患者的HAMD评分、PSQI评分和ASIQ评分明显较低,差异均有统计学意义(P<0.05)。治疗后,与西酞普兰组比较,联合治疗组患者的GDNF、5-HT、CAT、CD4+和CD3+水平明显较高,IL-2、IL-22、IL-1β、TAOC、8-OHdG和CD8+水平明显较低,差异均有统计学意义(P<0.05)。联合治疗组患者的总有效率为95.16%(59/62),明显高于西酞普兰组的83.61%(51/61),差异有统计学意义(P<0.05)。结论:多塞平联合艾司西酞普兰治疗抑郁症,可明显改善患者的抑郁情绪、睡眠质量和自杀意念,调控GDNF、5-HT水平,减轻炎症反应,改善患者抗氧化能力,治疗效果显著。OBJECTIVE:To explore the effects of doxepin combined with escitalopram on levels of glial cell-derived neurotrophic factor(GDNF)and 5-hydroxytryptamine(5-HT)in patients with depression.METHODS:Totally 123 patients admitted into Hainan Provincial Anning Hospital from Aug.2017 to Aug.2019 were extracted to be divided into the citalopram group(n=61)and the combined treatment group(n=62)via the random number table.The citalopram group was treated with escitalopram,while the combined treatment group received doxepin combined with escitalopram.Hamilton depression scale(HAMD)was used to evaluate the psychological depression of patients.Pittsburgh sleep quality index(PSQI)was used to evaluate the sleep quality of patients.Adult suicidal ideation questionnaire(ASIQ)was adopted to evaluate the suicidal ideation of patients.The levels of GDNF and 5-HT were detected by immunoturbidimetry.The levels of interleukin(IL)2,IL-22,IL-1β,total antioxidant capacity(TAOC),8-hydroxy-deoxyguanosine(8-OHDG)and catalase(CAT)were detected by enzyme-linked immunosorbent assay.The levels of T lymphocyte subsets were detected by flow cytometry.The therapeutic effects of two groups were observed.RESULTS:After treatment,compared with the citalopram group,the scores of HAMD,PSQI and ASIQ in the combined treatment group were lower,with statistically significant differences(P<0.05).After treatment,compared with the citalopram group,the levels of GDNF,5-HT,CAT,CD4+and CD3+in the combined treatment group were higher,and the levels of IL-2,IL-22,IL-1β,TAOC,8-OHdG and CD8+in the combined treatment group were lower,with statistically significant differences(P<0.05).The total effective rate of the combined treatment group was 95.16%(59/62),significantly higher than 83.61%(51/61)of the citalopram group,the difference was statistically significant(P<0.05).CONCLUSIONS:The efficacy of doxepin combined with escitalopram in the treatment of depression is significant,which can effectively improve the depression,sleep quality and suicidal ideation of patients

关 键 词：抑郁症 多塞平 艾司西酞普兰 胶质细胞源性神经营养因子 5-羟色胺 

分 类 号：R971[医药卫生—药品]