针灸联合黛力新治疗脑卒中后抑郁疗效及对患者血清神经递质水平的影响

目的:观察针灸联合黛力新对脑卒中后抑郁(PSD)患者的抗抑郁疗效以及对血清单胺类、氨基酸类神经递质水平的影响。方法:54例PSD患者随机分为观察组和对照组,各27例,两组均给予常规药物治疗,对照组给予黛力新治疗,观察组在对照组的基础上给予针灸治疗,共治疗4周。采用汉密尔顿抑郁评分量表(HAMD)评价治疗前后抑郁症状,并检测单胺类神经递质血清5-羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NE)及氨基酸类神经递质谷氨酸(GLU)、γ-氨基丁酸(GABA)含量的变化。结果:治疗后,观察组总有效率(88.9%)明显高于对照组(77.8%,χ^2=4.964,P<0.05)。两组HAMD评分在治疗后均下降(P<0.05),且观察组较对照组评分明显降低(P<0.05);观察组治疗后减分率明显高于对照组(P<0.05)。治疗后两组患者血清5-HT、DA、NE含量较治疗前明显增高(P<0.01),且观察组5-HT、DA、NE含量较对照组明显增高(P<0.01)。治疗后两组患者血清GLU含量较治疗前明显下降(P<0.01),且观察组GLU含量较对照组明显降低(P<0.01)。治疗后两组患者血清GABA含量较治疗前明显增高(P<0.01),且观察组GABA含量较对照组明显增高(P<0.01)。结论:针灸联合黛力新治疗可调节单胺类和氨基酸类神经递质含量,从而有效改善PSD患者抑郁症状。

Effects of Acupuncture combined with Deanxit on Post-stroke depression and its influence on serum neurotransmitters level

Objective:To observe the antidepressant effect of acupuncture combined with flupentixol and melitracen on post-stroke depression (PSD) patients and the effects on serum monoamines and amino acid neurotransmitters. Methods:Fifty-four patients with PSD were randomly divided into observation group ( n =27) and control group ( n =27). Both group were treated with routine medication. Control group was received flupentixol and melitracen. Observation group was conducted with flupentixol and melitracen combined with acupuncture. The Hamilton Depression Rating Scale was used to evaluate the symptom of depression before and after treatment. We tested monoamine neurotransmitters including serum serotonin (5-HT),dopamine (DA),norepinephrine (NE),and amino acid neurotransmitters including glutamate (GLU),gamma-aminobutyl Acid (GABA) content. Results: After treatment,the total effective rate of the observation group (88.9%) was significantly higher than that of the control group (77.8%,χ^2 =4.964, P <0.05). The HAMD scores of the two groups decreased after treatment ( P <0.05),and the scores of the observation group were significantly lower than those of the control group ( P <0.05). The reduction rate of the observation group was significantly higher than that of the control group ( P <0.05). After treatment,serum 5-HT,DA,NE levels in the two groups were significantly higher than those before treatment ( P <0.01),and the 5-HT,DA,NE levels in the observation group were significantly higher than those in the control group ( P <0.01). After treatment,serum GLU levels in the two groups were significantly lower than those before treatment ( P <0.01). The GLU content of the observation group was significantly lower than that of the control group ( P <0.01). After treatment,serum GABA levels in the two groups were significantly higher than those before treatment ( P <0.01). The GABA content in the observation group was significantly higher than that in the control group ( P <0.01). Conclusion :Acupuncture combined with flupentixol and melitracen can regulate the content of monoamines and amino acid neurotransmitters,thus effectively improving the depressive symptoms of PSD patients.