低阻抗意念导入疗法对抑郁症患者外周神经递质的影响

The influence of low resistance thought induction psychotherapy on the peripheral ;neurotransmitters of depression

目的：初步探讨低阻抗意念导入疗法（low resistance thought induction psychotherapy, TIP）对抑郁症患者下丘脑-垂体-肾上腺轴功能的影响，探讨其作用机制。方法以门诊抑郁症患者和健康志愿者为研究对象，分为TIP干预组（20例）与健康对照组（20例），健康对照组不进行任何干预，TIP干预组采用TIP技术干预，共6周。比较干预前后汉密顿抑郁量表（Hamilton Depression Scale, HAMD）、汉密顿焦虑量表（Hamilton Anxiety Scale, HAMA）评分；采用酶联免疫吸附法检测唾液皮质醇（cortisol, CORT）、血清5-羟色胺（5-hydroxytryptamine,5-HT）、血清脑源性神经营养因子（brain derived neurotrophic factor, BDNF）含量，评价临床疗效。结果治疗后，TIP 干预组 HAMD[（10.32±6.76）分比（1.50±1.47）分，t＝5.698]、HAMA[（8.21±5.12）分比（1.65±1.14）分；t＝5.589]均高于健康对照组（P＜0.01）；TIP 干预组血清5-HT[（29.64±8.98）nmol/ml 比（36.64±11.53）nmol/ml ， t＝2.107， P＝0.042]低于健康对照组；CORT[（9.55±2.86）nmol/ml 比（8.95±2.56）nmol/ml，t＝0.691，P＝0.494]、BDNF[（10.27±2.75）nmol/ml比（11.69±2.42）nmol/ml，t＝1.714，P＝0.095]与健康对照组相当。结论 TIP可改善抑郁症患者抑郁、焦虑状态；降低唾液CORT浓度，提高血清5-HT、BDNF浓度。

Objective To explorethe effect and mechanism of low resistance thought induction psychotherapy（TIP′s） on HPA axis function in patients with depression. Methods Twenty outpatients with depression were enrolled as the research object to 20 healthy subjucts, who were treated by the TIP for 6 weeks. The psychological index （HAMD, HAMA）, physiological indexes （salivary CORT, serum 5-HT, serum BDNF） were detected as the main evaluation index. Results After treatment,the HAMD （10.32 ± 6.76 vs. 1.50 ± 1.47, t=5.698）, HAMA （8.21 ± 5.12 vs. 1.65 ± 1.14, t=5.589） in the treatment group were significantly higher than those in the control group besides, the HAMD, HAMA scores in the intervention group were also significantly lower after treatment than before treatment （P〈0.01）. The serum 5-HT （29.64 ± 8.98 nmol/ml vs. 36.64 ± 11.53 nmol/ml, t=2.107, P=0.042） in the treatment group was significantly lower than that in the control group. The salivary CORT （9.55 ± 2.86 nmol/ml vs. 8.95 ± 2.56 nmol/ml, t=0.691, P=0.494）, and the serum BDNF （10.27 ± 2.75 nmol/ml vs.11.69 ± 2.42 nmol/ml, t=1.714, P=0.095） showed there were no significantly difference between two groups. Conclusions The TIP could treat the patients with depression by reducing the salivary CORT, and increase the serum 5-HT and serum BDNF.