CAJ | 학술논문

目的：探讨疏肝养心针刺法对选择性5－羟色胺再摄取抑制剂（ SSRIs）治疗抑郁症的增效作用以及其对血清5－羟色胺（5－HT）及辅助性T1细胞（ Th1细胞）／辅助性T2细胞（ Th2细胞）分泌的炎性细胞因子的影响。方法选取2013年1—12月杭州市第七人民医院精神科住院的抑郁症患者120例为研究对象，采用随机数字表法分为药物组60例和针药组60例，另选取同时期体检健康者60例为正常组。药物组和针药组患者分别于治疗前及治疗后1、2、4、6周评定蒙哥马利抑郁评定量表（ MADRS）评分，治疗后1、2、4、6周评定抗抑郁药副反应量表（ SERS）评分，评估临床疗效及不良反应情况，正常组、药物组和针药组分别于治疗前、治疗后6周检测血清5－HT及白介素（ IL）－1β、 IL－6、 IL－4、 IL－10水平。结果治疗前，药物组与针药组患者MADRS评分比较，差异无统计学意义（P＞0.05）。治疗后1、2、4、6周，针药组MADRS评分较药物组降低（P＜0.05）。治疗后1、2、4、6周，针药组SERS评分较药物组降低（ P＜0.05）。治疗前，药物组和针药组血清5－HT、 IL－4、 IL－10水平较正常组降低， IL－1β、 IL－6水平较正常组升高（ P＜0.05）；药物组与针药组血清5－HT、 IL－1β、 IL－6、 IL－4、 IL－10水平比较，差异无统计学意义（P＞0.05）。治疗后，针药组血清5－HT、 IL－4、 IL－10水平较药物组升高，血清IL－6水平较药物组降低（ P＜0.05）。结论疏肝养心针刺法能够快速、有效地增强SSRIs治疗抑郁症的临床疗效、减轻其不良反应，并能有效调节血清5－HT及Th1细胞／Th2细胞分泌的炎性细胞因子的失衡。
목적：탐토소간양심침자법대선택성5－간색알재섭취억제제（ SSRIs）치료억욱증적증효작용이급기대혈청5－간색알（5－HT）급보조성T1세포（ Th1세포）／보조성T2세포（ Th2세포）분비적염성세포인자적영향。방법선취2013년1—12월항주시제칠인민의원정신과주원적억욱증환자120례위연구대상，채용수궤수자표법분위약물조60례화침약조60례，령선취동시기체검건강자60례위정상조。약물조화침약조환자분별우치료전급치료후1、2、4、6주평정몽가마리억욱평정량표（ MADRS）평분，치료후1、2、4、6주평정항억욱약부반응량표（ SERS）평분，평고림상료효급불량반응정황，정상조、약물조화침약조분별우치료전、치료후6주검측혈청5－HT급백개소（ IL）－1β、 IL－6、 IL－4、 IL－10수평。결과치료전，약물조여침약조환자MADRS평분비교，차이무통계학의의（P＞0.05）。치료후1、2、4、6주，침약조MADRS평분교약물조강저（P＜0.05）。치료후1、2、4、6주，침약조SERS평분교약물조강저（ P＜0.05）。치료전，약물조화침약조혈청5－HT、 IL－4、 IL－10수평교정상조강저， IL－1β、 IL－6수평교정상조승고（ P＜0.05）；약물조여침약조혈청5－HT、 IL－1β、 IL－6、 IL－4、 IL－10수평비교，차이무통계학의의（P＞0.05）。치료후，침약조혈청5－HT、 IL－4、 IL－10수평교약물조승고，혈청IL－6수평교약물조강저（ P＜0.05）。결론소간양심침자법능구쾌속、유효지증강SSRIs치료억욱증적림상료효、감경기불량반응，병능유효조절혈청5－HT급Th1세포／Th2세포분비적염성세포인자적실형。
Objective To investigate the synergism of liver -soothing and heart -nourishing acupuncture therapy on the treatment of depressive disorder by selective serotonin reuptake inhibitors (SSRIs) and its influence on serum 5-HT and the inflammatory chemokines secreted by Th 1/Th2 cells.Methods Enrolled 120 depressive patients who were admitted into the Department of Psychiatry of Hangzhou Seventh People′s Hospital from January to December in 2013.Using random number table method, divided the patients into drug group (n=60) and acupuncture-drug group (n=60) .Another 60 healthy people were enrolled as normal group.In drug group and acupuncture -drug group, MADRS score was determined before treatment , 1 week, 2 weeks, 4 weeks and 6 weeks after treatment , SERS score was determined 1 week, 2 weeks, 4 weeks and 6 weeks after treatment, and clinical efficacy and adverse reaction were evaluated.Before treatment and 6 weeks after treatment , serum 5-HT, IL-1β, IL-6, IL-4 and IL-10 levels were tested in all three groups.Results Before treatment, drug group and acupuncture-drug group were not significantly different in MADRS score (P>0.05) .1 week, 2 weeks, 4 weeks and 6 weeks after treatment, acupuncture-drug group was lower (P<0.05) than drug group in MADRS score.1 week, 2 weeks, 4 weeks and 6 weeks after treatment, acupuncture-drug group was lower (P<0.05) than drug group in SERS score.Before treatment, drug group and acupuncture -drug group were lower in serum 5 -HT, IL-4 and IL-10 levels and higher ( P<0.05 ) in IL-1βand IL-6 levels than normal group; drug group and acupuncture group were not significantly different ( P>0.05 ) in serum 5-HT, IL-1β, IL-6, IL-4 and IL-10 levels.After treatment, acupuncture-drug group was higher (P<0.05) in serum 5-HT, IL-4 and IL-10 levels and lower in IL -6 level than drug group.Conclusion Liver-soothing and heart -nourishing acupuncture therapy could quickly and effectively enhance the clinical efficacy and reduce adverse reaction of SSRIs treatment of depressive disorder , and could effectively regulate the imbalance of serum 5 -HT and inflammatory cytokines secreted by Th1 /Th2 cells.