针刺对抑郁症患者康复及血清中细胞因子的影响

Effects of Electroacupuncture on Depressive Disorder Recovery and Serum Cytokines

目的探讨针刺百会、足三里对抑郁症患者康复疗效的影响及其相关机制。方法将90例抑郁症患者随机分为电针观察组、电针对照组、药物对照组。电针观察组取百会、足三里穴;电针对照组取太冲、三阴交、内关、神门穴;药物对照组给予百优解口服,20mg/次,每日1次。3组均治疗6周。在治疗前后分别用汉密尔顿抑郁量表(HAMD)评分。采用酶联免疫分析法(ELISA)检测血清中白细胞介素2(IL-2),白细胞介素4(IL-4)以及干扰素-γ(IFN-γ)的水平。结果与治疗前比较,治疗后3组患者的HAMD评分明显降低(P<0.01);临床疗效等级分布具有明显差异,提示针刺百会、足三里穴有较好的疗效;血清中IL-4水平较治疗前明显降低(P<0.01)。治疗后电针观察组和电针对照组血清中IL-2和IFN-γ升高(P<0.01,P<0.05),药物对照组也有升高,但无统计学意义。结论电针观察组与电针对照组比药物对照组起效快;电针观察组疗效优于电针对照组和药物对照组;3种治疗方法能够改善血清中IL-2、IL-4和IFN-γ的水平,从而改善抑郁症症状。但是3种治疗方法疗效比较没有差异。

Objective To explore the effect and mechanism of electroacupuncture at Baihui（GV20） and Zusanli（ST36） of patients with depression.Methods 90 patients were randomly divided into group A electroacupunctured at Baihui（GV20） and Zusanli（ST36）,group B electroacupunctured at Taichong（LR3）,Sanyinjiao（SP6）,Neiguan（PC6）,and Shenmen（H7） and group C treated with Fluoxetine （20 mg/d,6 weeks）. The therapeutic effect was assessed by the Hamilton Depression Rating Scale （HAMD） before and after treatment. Serum cytokine levels （IL-2,IL-4,and IFN-γ） were measured by ELISA assay at admission and after treatment （6 weeks）.Results Compared to pre-treatment,the mean levels of HAMD （ P0.01）and IL-4 （P 0.01） decreased significantly in all groups after treatment. Rank distribution of HAMD scores had obvious difference between all groups. The mean levels of IL-2 and IFN-γ had no significant difference in group C after treatment （P0.05）. And the mean levels of IL-2 and IFN-γ increased significantly in groups A and B after treatment（P0.01,P0.05）.Conclusion Electroacupuncture takes effect earlier than fluoxetine for depression. Electroacupuncture at Baihui（GV20） and Zusanli（ST36） was more effective than the other two methods. The three types of treatments can restore three types of cytokines and improve depressive syndrome.