益生菌联合帕罗西汀对母婴分离所致产后抑郁患者肠道菌群的影响  

Effect of probiotics combined with paroxetine on intestinal flora in patients with postpartum depression caused by mother-infant separation

作　　者：田甜 郝云梦 吴盟 Tian Tian;Hao Yunmeng;Wu Meng(Department of Clinical Nutrition,Xi'an Daxing Hospital,Xi'an 710082,China)

机构地区：[1]西安大兴医院临床营养科,西安710082

出　　处：《国际医药卫生导报》2024年第24期4231-4235,共5页International Medicine and Health Guidance News

基　　金：2024年度陕西省科技计划(2024SF-YBXM-077)。

摘　　要：目的探究益生菌联合帕罗西汀对母婴分离所致产后抑郁患者肠道菌群的影响。方法选取2020年5月至2023年5月在西安大兴医院分娩并诊治为由于母婴分离所致产后抑郁患者106例,根据治疗方法不同分为两组,各53例。对照组初产妇25例,经产妇28例,年龄(28.21±3.17)岁,予以口服帕罗西汀片治疗,20 mg/次,1次/d;观察组初产妇30例,经产妇23例,年龄(27.55±3.12)岁,予以益生菌(口服双歧杆菌四联活菌片,3片/次,3次/d)联合帕罗西汀治疗。两组患者均连续用药6周。比较两组临床疗效、炎症因子、神经内分泌、肠道菌群水平、生活质量及用药安全性。采用χ^(2)检验、t检验、秩和检验进行统计分析。结果观察组治愈、显效、有效、无效率分别为54.72%(29/53)、24.53%(13/53)、16.98%(9/53)、3.77%(2/53),对照组分别为37.74%(20/53)、22.64%(12/53)、22.64%(12/53)、16.98%(9/53),差异有统计学意义(Z=2.274,P=0.023)。治疗6周后,观察组的白介素-1β、丙二醛、CC趋化因子配体2均低于对照组[(4.63±1.54)ng/L比(5.58±1.86)ng/L、(2.95±0.51)mmol/L比(3.24±0.54)mmol/L、(431.63±72.27)ng/L比(483.41±80.56)ng/L],超氧化物歧化酶、5-羟色胺、多巴胺、神经肽Y均高于对照组[(124.51±13.84)U/L比(112.69±12.52)U/L、(194.33±14.95)μg/L比(185.64±14.28)μg/L、(3.94±0.61)μmol/L比(3.65±0.57)μmol/L、(15.28±2.21)mg/L比(13.47±2.07)mg/L],乳酸杆菌、双歧杆菌均高于对照组[(9.52±0.73)log N/g比(8.11±0.76)log N/g、(9.23±0.84)log N/g比(7.96±0.72)log N/g],差异均有统计学意义(均P<0.05);观察组匹兹堡睡眠质量指数低于对照组[(5.21±1.03)分比(5.84±1.16)分]、健康调查量表评分高于对照组[(83.25±6.41)分比(78.49±6.04)分],差异均有统计学意义(t=2.957、3.935,均P<0.05)。两组治疗期间均未出现明显不良反应。结论对母婴分离所致产后抑郁患者予以益生菌联合帕罗西汀治疗,可减轻炎症反应,促进神经内分泌功能,显Objective To explore the effect of probiotics combined with paroxetine on intestinal flora in patients with postpartum depression caused by mother-infant separation.Methods A total of 106 patients who gave birth in Xi'an Daxing Hospital from May 2020 to May 2023 and were diagnosed as postpartum depression caused by mother-infant separation were divided into two groups according to treatment methods,with 53 cases in each group.In the control group,25 primiparas and 28 multiparas,aged(28.21±3.17)years,were given oral paroxetine tablets,20 mg/time,once a day.In the observation group,30 primiparas and 23 multiparas,aged(27.55±3.12)years,were treated with probiotics(oral Bifidobacterium tetrad tablets,3 tablets/time,3 times/day)combined with paroxetine.Both groups were treated continuously for 6 weeks.The clinical efficacy,inflammatory factors,neuroendocrine,intestinal flora level,quality of life,and medication safety were compared between the two groups.χ^(2) test,t test,and rank sum test were used.Results In the observation group,the cure rate,significantly effective rate,effective rate,and ineffective rate were 54.72%(29/53),24.53%(13/53),16.98%(9/53),and 3.77%(2/53),respectively.In the control group,the cure rate,significantly effective rate,effective rate,and ineffective rate were 37.74%(20/53),22.64%(12/53),22.64%(12/53),and 16.98%(9/53),respectively.The curative effect of the observation group was better than that of the control group(Z=2.274,P=0.023).Six weeks after treatment,the levels of interleukin-1β,malondialdehyde,and CC chemokine ligand 2 in the observation group were lower than those in the control group[(4.63±1.54)ng/L vs.(5.58±1.86)ng/L,(2.95±0.51)mmol/L vs.(3.24±0.54)mmol/L,(431.63±72.27)ng/L vs.(483.41±80.56)ng/L],the levels of superoxide dismutase,5-hydroxytryptamine,dopamine,and neuropeptide Y were higher than those in the control group[(124.51±13.84)U/L vs.(112.69±12.52)U/L,(194.33±14.95)μg/L vs.(185.64±14.28)μg/L,(3.94±0.61)μmol/L vs.(3.65±0.57)μmol/L,(15.28±2.21)mg/L vs.(1

关 键 词：产后抑郁 母婴分离 帕罗西汀 双歧杆菌四联活菌片 肠道菌群 神经内分泌功能 

分 类 号：R749.4[医药卫生—神经病学与精神病学]