高压氧联合阿戈美拉汀治疗老年抑郁症患者68例疗效观察

Effect of hyperbaric oxygen combined with agomelatine on elderly patients with depression

目的探讨高压氧(HBO)联合阿戈美拉汀对老年抑郁症患者的临床疗效及对血清髓过氧化物酶(MPO)、成纤维细胞生长因子-22(FGF-22)水平的影响。方法选取2017年5月至2019年10月在空军特色医学中心干部病房和吉林市人民医院神经内科接受治疗的136例老年抑郁症患者作为研究对象。按照数字表法随机将患者分为观察组(n=68)和对照组(n=68)。对照组给予阿戈美拉汀治疗,观察组患者在对照组治疗的基础上加用HBO治疗,对比2组患者的临床疗效和不良反应的发生情况,以及在治疗前后焦虑评分、抑郁评分和血清指标肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、MPO、FGF-22水平的变化。结果治疗3个疗程后,观察组患者总有效率(91.2%)明显高于对照组(77.9%),差异有统计学意义(χ^2=4.561,P<0.05);2组患者汉密尔顿焦虑评分和抑郁评分均明显低于治疗前;且观察组患者治疗后的焦虑评分与抑郁评分显著低于对照组(P<0.05)。与治疗前比较,2组患者血清TNF-α、IL-1β、MPO水平明显降低,FGF-22水平明显升高;且观察组患者治疗后血清TNF-α、IL-1β、MPO水平显著低于对照组,FGF-22水平明显高于对照组,差异均有统计学意义(P<0.05)。结论HBO联合阿戈美拉汀治疗老年抑郁症患者具有较好的临床疗效,能够明显改善焦虑和抑郁症状,值得临床推广使用。

Objective To investigate the clinical effect of hyperbaric oxygen(HBO)combined with agomelatine on elderly patients with depression,and its effect on the levels of myeloperoxidase(MPO)and fibroblast growth factor-22(FGF-22)in serum.Methods A total of 136 elderly patients with depression treated in the Geriatrics Department of Air Force Special Medical Center and Neurology Department of Jilin People′s Hospital from May 2017 to December 2019 were randomly divided into observation group(n=68)and control group(n=68)by random number table method.The control group was treated with agomelatine,and the observation group was treated with HBO on the basis of the treatment of the control group.The clinical effect and adverse reaction after treatment,and anxiety score,depression score,and the changes of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),MPO,and FGF-22 of the two groups were compared before and after treatment.Results After 3 courses of treatment,the total effective rate(91.2%)in the observation group was significantly higher than that in the control group(77.9%),with statistically significant difference(χ^2=4.561,P<0.05).The anxiety scores measured by Hamilton Anxiety Rating Scale(HAM-A)and the depression scores of both groups were significantly reduced after treatment,and the anxiety score and depression score of the observation group were significantly lower than those of the control group,with statistically significant difference(P<0.05).The levels of TNF-α,IL-1β,and MPO in both groups were all significantly reduced after treatment,while the FGF-22 level in both groups was significantly increased.The levels of TNF-α,IL-1β,and MPO in the observation group were significantly lower than those in the control group,while the FGF-22 level in the observation group was significantly higher than that in the control group,with statistical differences(P<0.05).Conclusion HBO combined with agomelatine has a good clinical effect on elderly patients with depression by improving the symptoms of anxiety and depression,which is worthy of clinical popularization and application in clinic.