加味丹栀逍遥散联合脐带间充质干细胞治疗中风后抑郁症的临床观察

Therapeutic effect of Jiawei Danzhi Xiaoyao powder combined with intravenous human umbilical cord mesenchymal stem cells on post-stroke depression

目的:观测加味丹栀逍遥散联合人脐带间充质干细胞(HUC-MSCs)对中风后抑郁症的临床疗效,以及对血清中肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、IL-6、去甲肾上腺素(NE)、5-羟色胺(5-HT)和脑源性神经营养因子(BDNF)水平的影响。方法:中风后抑郁症患者60例,随机分为观察组和对照组,每组30例。观察组给予加味丹栀逍遥散联合人脐带间充质干细胞治疗,对照组给予加味丹栀逍遥散联合氟西汀治疗,2组疗程均为8周。分别在治疗前后用汉密尔顿抑郁量表(HAMD)对2组患者进行评定,ELISA法测定血清中IL-1β、IL-6、TNF-α、5-HT、NE和BDNF水平。结果:治疗8周后,观察组总有效率显著高于对照组(P<0.05),HAMD评分显著低于对照组(P<0.05),血清TNF-α、IL-1β和IL-6均显著低于对照组(P<0.05),而5-HT、NE和BDNF均显著高于对照组(P<0.05)。与同组治疗前比较,治疗后2组的HAMD评分均显著下降(P<0.05),血清TNF-α、IL-1β和IL-6均显著降低(P<0.05),而5-HT、NE和BDNF均显著增高(P<0.05)。结论:加味丹栀逍遥散联合人脐带间充质干细胞治疗中风后抑郁症疗效较好,其机制可能与加味丹桅逍遥散联合脐带间充质干细胞抗炎、增加单胺类神经递质释放、刺激脑内神经营养因子的分泌有关。

AIM:To observe the clinical therapeutic effect of Jiawei Danzhi Xiaoyao powder combined with transplantation of human umbilical cord mesenchymal stem cells(HUC-MSCs)in the treatment of post-stroke depression(PSD)patients and to detect the changes of the serum cytokine levels of the tumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-6,norepinephrine(NE),5-hydroxytry-ptamine(5-HT)and brain derived neurotrophic factor(BDNF).METHODS:The patients with PSD(n=60)were randomly divided into observation group and control group.The patients in observation group was given Jiawei Danzhi Xiaoyao powder combined with HUC-MSCs,and the patients in control group was given Jiawei Danzhi Xiaoyao powder combined with fluoxetine.The course of treatment was 8 weeks.The effects of the treatments on the patients were evaluated with Hamilton Depression Scale(HAMD).The serum levels of IL-1β,IL-6,TNF-α,5-HT,NE and BDNF were measured by ELISA.RESULTS:After 8 weeks of treatment,the total effective rate in observation group was significantly higher than that in control group(P<0.05).Compared with the same group before treatment,the HAMD scores and the serum levels of TNF-α,IL-1β,IL-6 of the 2 groups were significantly decreased after treatment(P<0.05),while 5-HT,NE and BDNF were significantly increased(P<0.05).After 8 weeks of treatment,the HAMD scores in observation group was significantly lower than that in control group(P<0.05),and the serum levels of TNF-α,IL-1β,IL-6 were significantly decreased in observation group(P<0.05),while 5-HT,NE and BDNF were significantly increased(P<0.05).CONCLUSION:Jiawei Danzhi Xiaoyao powder combined with human umbilical cord mesenchymal stem cells is effective in the treatment of post-stroke depression.The mechanism may be related to the effects of HUCMSCs such as anti-inflammatory effect,increased release of monoamine neurotransmitters,and stimulation of secretion of neurotrophic factors in the brain.