[1]蒋 岚,田慧军△,黄 伟.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[J].陕西中医杂志,2019,(8):1134-1137.
　JIANG Lan,TIAN Huijun,HUANG Wei..Effects of Acupuncture combined with Deanxit on Post-stroke depression and its influence on serum neurotransmitters level[J].,2019,(8):1134-1137.
点击复制

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
分享到：

《陕西中医》杂志[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2019年8期
页码:
1134-1137
栏目:
针灸经络
出版日期:
2019-08-05

文章信息/Info

Title:
Effects of Acupuncture combined with Deanxit on Post-stroke depression and its influence on serum neurotransmitters level
文章编号:
DOI:10.3969/j.issn.1000-7369.2019.08.041
作者:
蒋 岚1; 田慧军1△; 黄 伟2
1.北京北亚骨科医院神经内科（北京102445）；2.解放军309医院神经内科 （北京 100091）
Author(s):
JIANG Lan; TIAN Huijun; HUANG Wei.
The Department of Neurology,BeiYa Orthopaedic Hospital（Beijing 102445)
关键词:
脑卒中; 卒中后抑郁; 氟哌噻吨美利曲辛; 针灸; 神经递质; 疗效
Keywords:
Key words Stroke; Post-strokedepression;  Flupentixol and melitrace;  Acupuncture;  Neurotransmitter; Curative effect
分类号:
R741
文献标志码:
A
摘要:
摘 要 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。
Abstract:
Abstract 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.

参考文献/References:

[1] Vojtikiv-Samoilovska D，Arsovska A.Prevalence and predictors of depression after stroke-results from a prospective study[J].Open Access Maced J Med Sci,2018,6(5):824-828. 
[2] Robinson RG，Jorge RE.Post-stroke depression:A review[J].Am J Psychiatry， 2016,173(3):221-231.
[3] Carod-Artal FJ.Neurological rehabilitation and continuity of care after stroke[J].Neurologia,2011,26(3):190.
[4] Villa RF，Ferrari F，Moretti A.Post-stroke depression: Mechanisms and pharmacological treatment[J].Pharmacol Ther,2018,184:131-144.
[5] 黄晓琪,粱 琰.针灸疗法配合康复训练对脑梗死恢复期患者神经功能及生活质量的影响[J].陕西中医,2017,38(11):1589-1590.
[6] 肖 夏,魏京金,李维靖,等.针灸调控下丘脑-垂体-肾上腺轴抗抑郁的机理分析[J].上海针灸杂志,2016,35(6):758-760.
[7] 陈 杰,田慧军.针灸联合氟西汀对急性脑梗死伴抑郁患者神经功能、负性情绪及免疫功能的影响[J].针灸临床杂志,2017,33(7):32-35.
[8] 全国第四届脑血管病学术会议.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379.
[9] 中华医学会精神科分会.中国精神疾病分类与诊断标准[M].第3版.济南：山东科学技术出版社,2001:75-78.
[10] 张明园.精神科评定量表手册[M].长沙：湖南科学技术出版社,1998:81-84.
[11] 牛琦云.针灸结合通痹益脑汤治疗脑梗死后血管性痴呆临床观察[J].陕西中医,2017,38(11):1591-1592.
[12] Cully JA，Gfeller JD，Heise RA,et al.Geriatric depression，medical diagnosis，and functional recovery during acute rehabilitation[J].Arch Phys Med Rehabil,2005,86(12):2256-2260.
[13] 郑 龙.氟西汀对老年急性脑梗死后抑郁患者神经功能缺损的影响[J].中国老年学杂志,2013,33(19):4841-4842.
[14] 姜 磊,赵 军.针灸结合药物治疗脑卒中后抑郁的临床研究[J].针灸临床杂志,2011,27(11):15-17.
[15] Youn JI，Sung KK，Song BK，et al.Effects of electro-acupuncture therapy on post-stroke depression in patients with different degrees of motor function impairments: a pilot study[J].J Phys Ther Sci,2013,25(6):725-728.
[16] 冯 琬,杨耀军.针灸辅助治疗对脑卒中后抑郁患者血清细胞因子、神经递质的影响[J].海南医学院学报,2017,23(14):2010-2013.
[17] 李小莹,张志达,张 瑭.早期抗抑郁治疗对卒中后合并抑郁患者预后的影响[J].陕西医学杂志,2016,45(10):1344-1346.
[18] 赵 虹,袁 烨.黛立新治疗脑卒中后抑郁状态[J].中国临床医生,2008,36(11):39.
[19] Liu Y，Zhao J，Guo W.Emotional roles of mono-aminergic neurotransmitters in major depressive disorder and anxiety disorders[J].Front Psychol,2018,9:2201. 
[20] Hamon M，Blier P.Monoamine neurocircuitry in depression and strategies for new treatments[J].Prog Neuropsychopharmacol Biol Psychiatry,2013,45:54-63.
[21] Bystritsky A，Kerwin L，Feusner JD,et al.A pilot controlled trial of bupropion XL versus escitalopram in generalized anxiety disorder[J].Psychopharmacol Bull,2008,41(1):46-51.

相似文献/References:

[1]吴春岚,王长德,陈 婡.逍遥解郁方对卒中后抑郁大鼠5HT含量及其受体表达影响的研究*[J].陕西中医杂志,2019,(3):275.
　WU Chunlan,WANG Changde,CHEN Lai..Effect of Xiaoyao Jieyu recipe on 5HT content and its receptors expression of poststroke depressed rats[J].,2019,(8):275.
[2]金硕果,尹海燕,孙鸿辉△,等.三七对轻型缺血性脑卒中患者“双抗”治疗后出血事件影响的研究*[J].陕西中医杂志,2019,(3):287.
　JIN Shuoguo,YIN Haiyan,SUN Honghui,et al.Impact study of Panax notoginseng on hemorrhagic event after treatment of dual antiplatelet therapy in patients with acute minor stroke[J].,2019,(8):287.
[3]张子英,吴伯涛,翟清华.益气活血法与化痰通络疗法对脑卒中症状治疗的应用价值探讨[J].陕西中医杂志,2019,(2):250.
[4]樊锐敏.肝胃百合汤对脑卒中肠内营养患者胃肠道反应的影响[J].陕西中医杂志,2019,(1):52.
　FAN Ruimin..Effect of Ganwei Baihe decoction on gastrointestinal reaction in patients with cerebral apoplexy enteral nutrition[J].,2019,(8):52.
[5]常雪利.针灸治疗对脑卒中后偏瘫颈肩痛患者疼痛改善及预后的影响*[J].陕西中医杂志,2019,(4):525.
　CHANG Xueli..Analysis of the effect of acupuncture on pain improvement and prognosis in patients with hemiplegia neck shoulder and pain[J].,2019,(8):525.
[6]许文杰,蒋瑞冲,周一心,等.王翘楚教授经验方治疗肝郁瘀阻型脑卒中后失眠临床研究*[J].陕西中医杂志,2019,(7):867.
　XU Wenjie,Jiang Ruichong,Zhou Yixin,et al.Therapeutic observation of experience prescription in party of professor Wang Qiaochu for post-stroke insomnia due to liver depression and blood stasis bolck[J].,2019,(8):867.
[7]蔡丽,刘毅,陆小青,等.神经复元方治疗缺血性卒中后抑郁临床研究*[J].陕西中医杂志,2019,(11):1523.
　CAI Li,LIU Yi,LU Xiaoqing,et al.Shenjing Fuyuan decoction in the treatment of ischemic poststroke depression[J].,2019,(8):1523.
[8]萨仁,李长君,蔡海鑫.头穴丛刺对脑卒中后血管性痴呆患者认知功能及血清HIF1α的影响*[J].陕西中医杂志,2019,(11):1622.
　SA Ren,LI Changjun,CAI Haixin..Effect of scalp acupuncture on cognitive function and serum HIF1α in patients with vascular dementia after stroke[J].,2019,(8):1622.
[9]王 佳 ,沈卫东△.头针、舌针联合康复训练治疗脑卒中后吞咽障碍疗效研究*[J].陕西中医杂志,2019,(12):1774.
　WANG Jia,SHEN Weidong..Efficacy of scalp acupuncture and tongue acupuncture combined with rehabilitation training on dysphagia after cerebral stroke[J].,2019,(8):1774.
[10]刘兰兰,耿翊宁.经穴针刺对老年脑卒中患者脑灌注及血小板反应蛋白1水平影响研究[J].陕西中医杂志,2019,(12):1778.
　LIU Lanlan,GENG Yining..Effect of acupoint acupuncture on cerebral perfusion and thrombospondin 1 in senile patients with stroke[J].,2019,(8):1778.
[11]罗 玮,李 耘,刘 玲.加味涤痰汤治疗卒中后抑郁疗效及对患者外周血NF-κB、miR-146a表达的影响[J].陕西中医杂志,2019,(8):1029.
　LUO Wei,LI Yun,LIU Ling..Clinical effect of Jiawei Ditan decoction on post-stroke depressionand the expression of NF-κB and miR-146a in peripheral blood[J].,2019,(8):1029.

更新日期/Last Update: 2019-08-15