醒神启闭针刺法对脑卒中后抑郁的疗效及5-HT、NGF、IL-23的影响

Effect of Inducing Resuscitation and Opening and Closing Acupuncture on Post-stroke Depression and Effect on 5-HTF and IL-23 in Patients with Stroke

目的分析醒神启闭针刺法对脑卒中后抑郁的疗效及患者5-羟色胺(5-HT)、神经生长因子(NGF)、白细胞介素-23(IL-23)的影响。方法选取医院2017年7月—2018年12月收治的脑卒中后抑郁患者90例,按照入院顺序分为两组。对照组给予度洛西汀治疗,观察组给予醒神启闭针刺法治疗,分析两组患者治疗后的临床效果。结果两组治疗前汉密尔顿抑郁量表(HAMD)评分、美国国立卫生院脑卒中量表(NIHSS)评分组间比较,差异不具有统计学意义(P>0.05)。观察组治疗后HAMD评分(12.04±2.16)分、NIHSS评分(6.12±1.21)分低于对照组(P<0.05)。两组治疗前神经细胞因子、IL-23、白细胞介素-1β(IL-1β)、白细胞介素-2(IL-2)水平组间比较,差异不具有统计学意义(P>0.05)。观察组治疗后5-HT(46.85±6.02)ng/mL、脑源性神经营养因子(BDNF)(42.98±5.97)ng/mL、NGF(12.77±1.30)ng/L水平高于对照组,IL-23(69.58±9.53)ng/L、IL-1β(18.15±2.14)ng/L、IL-2(42.63±8.15)pg/mL水平低于对照组(P<0.05)。结论醒神启闭针刺法可改善脑卒中后抑郁患者神经功能,减轻抑郁症状,降低炎症反应,提高神经细胞因子的表达。

Objective To analyze the effect of inducing resuscitation and opening and closing acupuncture on post-stroke depression and the effects of 5-HT,nerve growth factor(NGF) and IL-23(IL-23) in patients with cerebral apoplexy. Methods From July 2017 to December 2018, 90 patients with post-stroke depression were divided into two groups according to the order of admission. The control group was treated with doloxetine, and the observation group was treated with inducing resuscitation and opening and closing acupuncture. The clinical effect of the two groups after treatment was analyzed. Results There was no significant difference in Hamilton depression scale(HAMD) score or National Hospital Stroke scale(NIHSS) score between the two groups before treatment(P>0.05). After treatment, the HAMD score and NIHSS score in the observation group were 12.04±2.16 and 6.12±1.21, respectively, which were lower than those in the control group(P<0.05). There was no significant difference in the levels of IL-23, IL-1β and IL-2 between the two groups before treatment(P>0.05). After treatment, the levels of 5-HT[(46.85±6.02)ng/mL], brain-derived neurotrophic factor(BDNF)[(42.98±5.97)ng/mL] and NGF[(12.77±1.30)ng/L] in the observation group were higher than those in the control group, and the level of IL-23 [(6958±9.53)ng/L] in the observation group was higher than that in the control group. The levels of IL-1β [(18.15±2.14)ng/L] and IL-2 [(42.63±8.15)pg/mL] were lower than those of the control group(P<0.05). Conclusion The inducing resuscitation and opening and closing acupuncture can improve the neurological function, reduce the depressive symptoms, reduce the inflammatory reaction and increase the expressions of nerve cell factors in patients with post-stroke depression.