基于谷氨酸和γ-氨基丁酸水平探讨疏肝调神针法对轻度抑郁症的影响  

Effects of acupuncture method of soothing the liver qi and regulating the spirit on mild depression based on levels of glutamate and γ-aminobutyric acid

作　　者：李仲贤 符文彬[3] 阎路达 李晶晶[1,2] 刘明[1,2] 封艳艳[1,2] 梁峻铨 周夏芸 陈锐明 石国傲 吉祥 周鹏 LI Zhongxian;FU Wenbin;YAN Luda;LI Jingjing;LIU Ming;FENG Yanyan;LIANG Junquan;ZHOU Xiayun;CHEN Ruiming;SHI Guoao;JI Xiang;ZHOU Peng(Seventh Clinical Medical College of Guangzhou University of Chinese Medicine,Shenzhen 518133,China;Shenzhen Bao'an Traditional Chinese Medicine Hospital,Shenzhen 518133,China;Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第七临床医学院,深圳518133 [2]深圳市宝安区中医院,深圳518133 [3]广东省中医院,广州510120

出　　处：《中华中医药杂志》2023年第10期5099-5104,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.82074522,No.81774411);广东省中医药局项目(No.20231279);深圳市科技计划项目(No.JCYJ20220530141414032);深圳市宝安区中医药发展基金(No.2020KJCX-KTYJ-10)。

摘　　要：目的:观察疏肝调神针法对轻度抑郁症患者抑郁状态及大脑皮层兴奋性的影响,结合其外周血清谷氨酸(GLU)和γ-氨基丁酸(GABA)水平,共同探讨疏肝调神针法治疗抑郁症的潜在作用机制。方法:将68例轻度抑郁症患者随机分为观察组和对照组,每组34例。观察组采用疏肝调神针法治疗,对照组采用假针刺治疗,治疗6周后比较疗效。评价两组患者治疗前后汉密尔顿抑郁量表(HAMD-17)、症状自评量表(SCL-90)、大脑皮层静息运动阈值(rMT)、皮质静息期(CSP)、外周血清GLU以及GABA水平的变化情况。结果:治疗后,观察组HAMD-17评分、SCL-90总分和抑郁因子评分、大脑皮层rMT水平及外周血清GLU水平均较治疗前显著降低(P<0.01),且均显著低于对照组(P<0.05,P<0.01);观察组大脑CSP水平、外周血清GABA水平均较治疗前升高(P<0.01),且均显著高于对照组(P<0.01);观察组总有效率[90.91%(30/33)]显著高于对照组[63.64%(21/33)](P<0.01);两组HAMD-17评分与大脑皮层rMT(r=0.395,P=0.001)和血清GLU(r=0.263,P=0.033)水平呈正相关,与大脑CSP(r=-0.270,P=0.028)和血清GABA水平(r=-0.327,P=0.007)呈负相关,且大脑CSP和血清GABA水平(r=0.291,P=0.018)呈正相关。结论:疏肝调神针法可有效改善轻度抑郁症患者的抑郁症状,降低其大脑皮层rMT和血清GLU水平,并提高其大脑CSP和血清GABA水平,其作用机制可能与针刺重塑中枢与外周GLU、GABA水平的新平衡有关。Objective:To observe the effects of the acupuncture method of soothing the liver qi and regulating the spirit on the depressive state and cortical excitability of patients with mild depression,combined with their peripheral serum glutamate(GLU)andγ-aminobutyric acid(GABA)levels,and to jointly explore the potential mechanism of the acupuncture method of soothing the liver qi and regulating the spirit in the treatment of depressive disorders.Methods:Sixty-eight patients with mild depression were randomly divided into an observation group and a control group,34 cases in each group.The observation group was treated with the acupuncture method of soothing the liver qi and regulating the spirit,while the control group was treated with sham acupuncture,and the efficacy was compared after 6 weeks of treatment.The changes of Hamilton depression scale(HAMD-17),symptom self-rating scale(SCL-90),cortical resting motor threshold(rMT),cortical silent period(CSP),peripheral serum GLU and GABA levels were evaluated before and after treatment in the two groups.Results:After treatment,the HAMD-17 score,total SCL-90 score and depression factor score,cortical rMT level and serum GLU level in the observation group were all lower than those before treatment(P<0.01),and all were significantly lower than those in the control group(P<0.05,P<0.01);brain CSP level and serum GABA level in the observation group were higher than before treatment(P<0.01),and all were significantly higher than those in the control group(P<0.01);the total effective rate was 90.91%(30/33)in the observation group and 63.64%(21/33)in the control group,and the efficacy of the observation group was significantly better than that of the control group(P<0.01);HAMD-17 scores in both groups were positively correlated with rMT(r=0.395,P=0.001)and serum GLU(r=0.263,P=0.033)levels,and negatively correlated with CSP(r=-0.270,P=0.028)and serum GABA levels(r=-0.327,P=0.007),and CSP and GABA levels(r=0.291,P=0.018)were positively correlated.Conclusion:The acupuncture method of

关 键 词：轻度抑郁症 疏肝调神针法 谷氨酸 Γ-氨基丁酸 静息运动阈值 皮质静息期 

分 类 号：R246.6[医药卫生—针灸推拿学]