解郁兴阳汤对抑郁症患者神经递质、SHBG、ChE和Netrin-1表达的影响

Effects of Jieyu Xingyang Decoction(解郁兴阳汤)on the Expressions of Neurotransmitters,SHBG,ChE and Netrin-1 in Patients with Depression

目的:探讨解郁兴阳汤治疗抑郁症患者的疗效及对患者神经递质、激素结合蛋白(SHBG)、胆碱酯酶(Ch E)和神经轴突导向因子-1(Netrin-1)表达的影响。方法:将140例抑郁症患者随机分为治疗组与对照组各70例。对照组患者口服盐酸舍曲林片,治疗组患者在对照组基础上口服解郁兴阳汤。两组患者均治疗4周。比较两组患者治疗前后主要症状积分、汉密尔顿抑郁量表(HAMD)评分、神经递质[5羟色胺(5-HT)、去甲肾上腺素(NE)和多巴胺(DA)]、SHBG、Ch E和Netrin-1水平变化,并评价疗效及不良反应。结果:治疗组总有效率(90.00%,63/70)高于对照组(77.14%,54/70),差异有统计学意义(P<0.05);治疗4周后,两组患者情绪抑郁、腰膝酸软、疲倦乏力和畏寒肢冷积分均低于治疗前(P<0.05),且治疗组患者情绪抑郁、腰膝酸软、疲倦乏力和畏寒肢冷积分均低于对照组(P<0.05);治疗4周后,两组患者HAMD评分均低于治疗前(P<0.05),且治疗组患者HAMD评分低于对照组(P<0.05);治疗4周后,两组患者血清5-HT、NE、DA、Ch E和Netrin-1水平均高于治疗前(P<0.05),血清SHBG水平低于治疗前(P<0.05),且治疗组患者血清5-HT、NE、DA、Ch E和Netrin-1水平均高于对照组(P<0.05),血清SHBG水平低于对照组(P<0.05);治疗组不良反应发生率低于对照组(P<0.05)。结论:解郁兴阳汤治疗抑郁症患者疗效良好,可提高患者血清5-HT、NE和DA水平,下调SHBG表达,上调Ch E和Netrin-1表达。

Objective:To investigate the therapeutic effect of Jieyu Xingyang Decoction in the treatment of patients with depression and its influence on the expression of neurotransmitter,hormone binding protein(SHBG),cholinesterase(Ch E)and axon guidance factor-1(Netrin-1).Methods:A total of 140 patients with depression were randomly divided into treatment group and control group,with 70 cases in each group.Sertraline hydrochloride tablets were taken orally in the control group,and Jieyu Xingyang Decoction was taken orally in the treatment group on the basis of the control group.The treatment course of the two groups was 4 weeks.The main symptom scores,Hamilton Depression Scale(HAMD)score,neurotransmitters[5-hydroxytryptamine(5-HT),norepinephrine(NE)and dopamine(DA)],SHBG,Ch E and Netrin-1 levels were compared between the two groups before and after treatment,and the curative effect and adverse reactions were evaluated.Results:The total effective rate in the treatment group(90.00%,63/70)was higher than that in the control group(77.14%,54/70),and the difference was statistically significant(P<0.05).After 4 weeks of treatment,the scores of emotional depression,soreness and weakness of waist and knees,fatigue and awe of cold limbs in the two groups were lower than those before treatment(P<0.05),and the scores of emotional depression,soreness and weakness of waist and knees,fatigue and awe of cold limbs in the treatment group were lower than those in the control group(P<0.05).After 4weeks of treatment,the HAMD scores in the two groups were lower than those before treatment(P<0.05),and the HAMD scores in the treatment group were lower than those in the control group(P<0.05).After 4 weeks of treatment,the serum levels of 5-HT,NE,DA,Ch E and Netrin-1 in the two groups were higher than those before treatment(P<0.05),and the serum SHBG level was lower than that before treatment(P<0.05).The serum levels of 5-HT,NE,DA,Ch E and Netrin-1 in the treatment group were higher than those in the control group(P<0.05),and the serum SHBG level was lower than that in the control group(P<0.05).The incidence of adverse reactions in the treatment group was lower than that in the control group(P<0.05).Conclusion:Jieyu Xingyang Decoction has a good effect on patients with depression,which can improve the serum levels of 5-HT,NE and DA,down-regulate the expression of SHBG,and up-regulate the expression of Ch E and Netrin-1.