运动对抑郁症症状、认知功能和γ-氨基丁酸影响的对照研究

Control study of exercise’ influence on depression’s symptom,cognitive function and GABA

目的探讨运动行为干预对抑郁症症状和认知功能的影响,同时检测抑郁症患者体内γ-氨基丁酸(GABA)神经递质的变化,探讨运动干预改善抑郁症可能的生化机制。方法选取2018年11月-2019年4月安徽省精神卫生中心住院的65例成年抑郁症患者予以编号,然后采取抽签法抽取号码随机分组,分为干预组(35例)和对照组(30例),5例干预组患者脱落。干预组运动方法为在跑步机上接受每周3~5次,每次35 min左右的慢跑有氧运动,运动时间为6周。运动前做10 min左右的热身运动,慢跑20 min左右,最后做5 min左右的缓慢运动。运用跑步机测量患者运动前后心率,使患者的最高训练心率能够控制在(220-年龄)×70%。干预组和对照组同时服用抗抑郁药物舍曲林(最大剂量为150 mg/d)治疗。采用汉密尔顿抑郁量表(HAMD)评分评估抑郁症症状,采用蒙特利尔认知评定量表(MoCA)评估认知功能,采用酶联免疫吸附试验法测量人体血浆中γ-氨基丁酸含量。2组间比较采用独立样本t检验,组内治疗前后比较采用配对样本t检验。结果对照组治疗前后HAMD分数差值为(-32. 73±4. 71)分,干预组治疗前后HAMD差值为(-24. 23±8. 95)分,运动结合抗抑郁药物治疗后抑郁症状显著改善(P <0. 01);对照组MoCA总分为(21. 77±1. 47)分,干预组MoCA总分为(25. 23±1. 16)分,运动结合抗抑郁药物治疗后认知功能显著改善(P <0. 01);对照组GABA浓度治疗前后差值为(0. 32±1. 54) mg/L,干预组GABA浓度治疗前后差值为(1. 87±0. 73) mg/L,运动结合抗抑郁药物治疗后GABA浓度明显上升(P <0. 01)。结论运动干预可以改善抑郁症症状和认知功能,可以提高体内GABA含量。

Objective To explore the effects of exercise on the symptoms,cognitive function and GABA in depression,as well as the possible biochemical mechanisms of exercise intervention in depression. Methods A total of 65 adult patients with depression from Anhui Mental Center were selected and numbered. Then the numbers were randomly divided by the lottery method. Patients( n = 65) were divided into intervention group( n = 35) and control group( n = 30). 5 patients in intervention group became detached. The intervention group took aerobic exercise on a treadmill about 35 minutes per day in a frequency of 3 to 5 times a week for 6 weeks. The whole exercise included a warm-up exercise for about10 minutes before exercise,jogging for about 20 minutes,and a slow-down exercise for about 5 minutes. The heart rate of the patient was measured by using a treadmill before and after exercise,and the patient’s highest training heart rate was controlled at( 220-age)× 70%. Besides,both of the intervention and the control group were treated with antidepressant sertraline( maximum dose of 150 mg/d). Depression symptoms were assessed by the Hamilton Depression Rating Scale. Cognitive function was assessed by the Montreal Cognitive Rating Scale. The GABA levels in human plasma were measured by enzyme-linked immunosorbent assay. The t-test of independent samples was used to compare sample data before and after treatment for the same group,while the t-test of paired samples were adopted for inter-group data. Different data were compared by the obtained means and variances. Results The difference of HAMD reduction scores were(-32. 73 ± 4. 71) for the control group and(-24. 23 ± 8. 95) for the intervention group. Total score of MoCA in the control group was( 21. 77 ± 1. 47),and in the intervention one was( 25. 23 ± 1. 16). The difference of GABA concentration in the control group before and after treatment was( 0. 32 ± 1. 54) mg/L,and in the intervention group was( 1. 87 ±0. 73) mg/L. Exercise combined with antidepressant drugs significantly relieves depressive symptoms( P < 0. 01). Conclusion Exercise can relieve depressive symptoms and improve cognitive function of depression and increase the GABA levels in human plasma of depression.