帕罗西汀联合银杏叶片治疗血管性抑郁对血清BDNF的影响及疗效观察

The efficacy study and influence on serum BDNF of combined treatment with folium ginko preparation and paroxetine in vascular depression

目的探讨帕罗西汀联合银杏叶片治疗血管性抑郁对血清脑源性神经营养因子(BDNF)的影响及临床疗效。方法 90例血管性抑郁患者,随机分为帕罗西汀联合银杏叶片治疗组(联用组)47例和单用帕罗西汀治疗组(单用组)43例,疗程8周,采用汉密尔顿抑郁量表(HAMD)评价临床疗效,用酶联免疫吸附法测定血清BDNF浓度,和90例正常对照人群BDNF浓度作组间比较。结果①两组治疗8周以后HAMD评分与同组治疗前相比差异有统计学意义(P<0.01);②治疗8周以后联用组有效率高于单用组,两组有效率及HAMD总分差异有统计学意义(P<0.01);③联用组与单用组治疗前血清BDNF水平,均低于正常对照组,有统计学意义(P<0.01);④治疗8周以后联用组和单用组血清BDNF浓度均高于治疗前水平,有统计学意义(P<0.01);⑤治疗8周后联用组与单用组、正常对照组3组血清BDNF浓度差异无统计学意义(P>0.05)。结论帕罗西汀联合银杏叶片治疗血管性抑郁比单用帕罗西汀治疗更为有效,二者均能显著提高血清BDNF水平,血清BDNF水平的提高可能是抗抑郁药物起效的作用机制之一。

Objective To investigate the efficacy and influence on serum brain-derived neurotrophic factor（BDNF） of combined treatment with Paroxetine and Folium Ginko Preparation in vascular depression.Methods Patients with vascular depression（n=90）wererandomly divided into Folium Ginkgo preparation combined with Paroxetine group（combined therapy group,n=47） and single paroxetine group（single group,n=43）.The treatment course was 8 weeks.The clinical efficacy was measured by the Hamilton depression scale（HAMD）.Serum BDNF concentrations were measured by ELISA and were compared between patients with vascular depression and 90 healthy people.Results ①After 8 weeks treatment,the HAMD score of both treatment groups were better than their scores before treatment（P0.01）;② the effective rate of the Folium Ginkgo preparation combined with Paroxetine group was better than the control group.There was statistical difference in the two groups（P0.01）;③ before treatment,the level of serum BDNF of both groups were lower than healthy people（P0.01）;④after 8 weeks treatment,the level of serum BDNF in two groups were higher than their level before treatment（P0.01）;⑤ after 8 weeks treatment,there were no significant difference among treatment group,control group and health group（P0.05）.Conclusion The efficacy of combined treatment of Folium Ginkgo preparation and Paroxetine in vascular depression was better and safer than single Paroxetine.Both treatment improve the level of serum BDNF.The increased serum BDNF may be the mechanism of antidepressant drugs.