乌灵胶囊联合艾司西酞普兰对抑郁症症状改善及Nrf2/ARE信号通路的干预作用

Wuling Capsule(乌灵胶囊)Combined with Escitalopram on Improvement of Symptoms in Depression Patients and Intervention Effect of Nrf2/ARE Signaling Pathway

目的探讨乌灵胶囊联合艾司西酞普兰对抑郁症患者症状改善及核因子E2相关因子2(Nrf2)/抗氧化反应元件(ARE)信号通路的干预作用。方法选择86例诊断为抑郁症的患者作为研究对象,采用随机数字法平均分为观察组与对照组两组:对照组43例给予艾司西酞普兰,观察组43例给予乌灵胶囊联合艾司西酞普兰治疗。随访3月,于治疗前、治疗后14 d、21 d、1个月、3个月采用汉密尔顿抑郁量表(HAMD)检测抑郁症状,于治疗前、治疗后3月采用实时荧光定量PCR检测外周血Nrf2/ARE mRNA表达情况。结果观察组睡眠、焦虑/躯体化、迟缓改善时间均明显少于对照组(P<0.05);绝望感改善时间比较差异无统计学意义(P>0.05)。观察组总有效率为88.4%(38/43),明显高于对照组(65.1%,28/43)(P<0.05)。观察组治疗后14 d开始HAMD评分逐渐降低(P<0.05);对照组治疗后21 d开始HAMD评分逐渐降低(P<0.05)。治疗后14 d、21 d、1个月及3个月观察组HAMD评分均低于对照组(P<0.05)。治疗后3月两组Nrf2及ARE mRNA表达均低于治疗前(P<0.05);治疗后3月观察组Nrf2及ARE mRNA表达均低于对照组(P<0.05)。结论乌灵胶囊联合艾司西酞普兰可以加快抑郁症症状改善,特别是睡眠障碍症状改善,同时降低氧化应激Nrf2/ARE信号通路功能,值得临床应用。

Objective To investigate the effect of Wuling Capsule(乌灵胶囊)combined with escitalopram on the improvement of symptoms in depression patients and the intervention of nuclear factor E2 related factor 2(Nrf2)/antioxidant response element(ARE)signaling pathway.s Methods Eighty-six patients diagnosed as depression were selected as the research object,and they were divided into observation group and control group by random number method.Forty-three cases in the control group were given escitalopram and the other 43 cases in the observation group were given Wuling Capsule combined with escitalopram treat-ment.Followed up for 3 months,the Hamilton Depression Scale(HAMD)was used to detect depressive symptoms before treat-ment,14 d,21 d,1 and 3 months after treatment,and real-time fluorescence quantitative PCR was used to detect peripheral blood Nrf2/ARE mRNA expression before and after treatment.s Results The improvement time of sleep,anxiety/somatization and delay in the observation group was significantly shorter than that in the control group(P<0.05).There was no difference in the improvement time of despair(P>0.05).The total effective rate in the observation group was 88.4%(38/43),which was signif-icantly higher than that in the control group(65.1%,28/43)(P<0.05).The HAMD score was gradually decreased 14 d after treatment in the observation group(P<0.05).The HAMD score was gradually decreased 21 d after treatment in the control group(P<0.05).The HAMD score of the observation group was lower than that of the control group 14 d,21 d,1 and 3 months after treatment(P<0.05).The expression of Nrf2 and ARE mRNA in both groups was lower than that before treatment and 3 months after treatment(P<0.05).The expressions of Nrf2 and ARE mRNA in observation group were lower than those of the control group 3 months after treatment(P<0.05).n Conclusion Wuling Capsule combined with escitalopram can accelerate the improvement of depression symptoms,especially the improvement of sleep disorders,and at the same time reduce the function of oxidative stress Nrf2/ARE signaling pathway,worthy of clinical application.