针刺联合氟西汀对卒中后抑郁症疗效及HPA轴功能的影响

Effects of acupuncture combined with medicine on hypothalamic pituitary adrenal axis in post stroke depression patients

目的:观察针刺联合氟西汀治疗卒中后抑郁症(PSD)的疗效并探讨其神经内分泌机制。方法:40例PSD患者随机分为两组,对照组20例单纯使用氟西汀治疗6周,研究组20例采用针刺结合氟西汀治疗6周。观察两组疗效和治疗前后血浆ACTH、CORT的含量变化。结果:治疗后两组临床疗效和ACTH、CORT值均有明显改善,研究组尤甚(P<0.05或0.01)。结论:针刺联合药物治疗PSD和单纯使用药物治疗相比,能够更好地改善患者的抑郁状态,其机理可能与抑制下丘脑-垂体-肾上腺(HPA)轴功能亢进有关。

Objective： To investigate the clinical effects of acupuncture combined with medicine and explore the neuroendocrine mechanism in post-stroke-depression patients. Methods： 40 cases with PSD were randomly divided into treatment group treated with acupuncture combined with Fluoxetine for 6 weeks and control group treated with Fluoxetine for 6 weeks, arid the therapeutic effects were observed and the plasma concentrations of ACTH, CORT were detected before and after treatment. Results： After 6 weeks, therapeutic effect and the plasma concentrations of ACTH and CORT were significantly improved in beth groups in comparison to that of before treatment, and treatment group was better than control group （P〈0.05or0.01）.Conclusions： Acupuncture combined with medicine can improve therapeutic effects and the probable mechanism is that acupuncture combined with medicine can regulate the balance of HPA more effectively.