针药并用对卒中后抑郁症患者脑电图和血清NE、NSE、IL-6、TNF-a水平的影响

Effect of Acupuncture plus Medication on Electroencephalogram and the Levels of Serum NE,NSE,IL-6 and TNF-a in Post-stroke Depression Patients

目的观察针药并用对卒中后抑郁症(PSD)患者脑电图和血清去甲肾上腺素(NE)、神经元特异性烯醇化酶(NSE)、白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平的影响。方法将96例PSD患者随机分为治疗组和对照组,每组48例。对照组在常规治疗基础上口服盐酸氟西汀胶囊,治疗组在对照组基础上加用醒脑开窍针法治疗。观察两组治疗前后汉密尔顿抑郁量表(HAMD)评分和脑电图变化,并观察血清去甲肾上腺素(NE)、神经元特异性烯醇化酶(NSE)、白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平差异。结果两组治疗后HAMD评分及血清NSE、IL-6、TNF-α水平均较治疗前降低,治疗组低于对照组;两组治疗后血清NE水平均较治疗前升高,治疗组高于对照组;差异均有统计学意义(P<0.05)。两组治疗后脑电图等级分布均较治疗前显著改善,治疗组优于对照组(P<0.05)。结论醒脑开窍针法联合常规西药治疗可显著减轻PSD患者抑郁程度,改善脑电图情况、神经功能和炎症反应,优于常规西医治疗。

Objective To observe the effect of acupuncture plus medication on electroencephalogram(EEG)and the levels of serum noradrenaline(NE),neuron-specific enolase(NSE),interleukin(IL)-6 and tumor necrosis factor(TNF)-α in post-stroke depression(PSD)patients.Method Ninety-six PSD patients were randomized into a treatment group and a control group,with 48 cases in each group.The control group was intervened by oral administration of Fluoxetine hydrochloride capsules in addition to the conventional intervention,and the treatment group was given Xingnao Kaiqiao(brain awakening and orifice opening)needling method in addition to the intervention given to the control group.The Hamilton Depression Scale(HAMD)score and EEG of the two groups were observed before and after treatment,as well as the serum levels of NE,NSE,IL-6 and TNF-α.Result The HAMD score and the serum levels of NSE,IL-6 and TNF-α declined after intervention in the two groups,and the treatment group was lower than the control group;the level of serum NE increased after intervention in both groups,and the treatment group was higher than the control group.The differences were all statistically significant(P<0.05).After intervention,the EEG grading showed improvement in both groups,and the treatment group was superior to the control group(P<0.05).Conclusion Xingnao Kaiqiao needling method plus conventional Western medication can significantly reduce the depression degree in PSD patients,improve the EEG reading,neurological function and inflammatory reaction.This method is superior to conventional Western medicine treatment.