针刺联合重复经颅磁刺激治疗脑卒中后抑郁对血清BDNF、IL-1β、IL-6、TNF-α水平的影响

Effect of Acupuncture Combined with Repetitive Transcranial Magnetic Stimulation on Serum BDNF,IL-1β,IL-6 and TNF-αLevels in Patients with Post-stroke Depression

目的:观察针刺联合重复经颅磁刺激治疗脑卒中后抑郁对血清BDNF、IL-1β、IL-6、TNF-α水平的影响。方法:64例随机分为对照组和观察组各32例。对照组给予草酸艾司西酞普兰治疗,观察组给予针刺联合高频重复经颅磁刺激治疗,均连续治疗4周。结果:两组治疗后HAMD评分均较治疗前降低,观察组治疗4周末HAMD评分下降更为明显(P<0.05)。治疗后两组血清BDNF水平均较治疗前升高,血清IL-1β、IL-6、TNF-α水平均较前下降,观察组在治疗4周后BDNF升高、IL-1β、IL-6、TNF-α降低较对照组更为明显(P<0.05)。结论:针刺联合高频重复经颅磁刺激能有效改善脑卒中后抑郁症状,疗效优于单用药物治疗,其作用机制可能与提高血清BDNF水平,降低血清IL-1β、IL-6、TNF-α水平有关。

Objective:To observe the effect of acupuncture combined with repetitive transcranial magnetic stimulation on serum BDNF,IL-1β,IL-6 and TNF-αlevels in patients with post-stroke depression.Methods:Sixty-four cases were randomly divided into the control group and the observation group,32 cases in each group.The control group were treated with escitalopram oxalate,while the observation group were treated with acupuncture combined with high-frequency repetitive transcranial magnetic stimulation.Both groups were treated for 4 weeks.Results:The HAMD scores of the two groups were lower than those before treatment,and the HAMD scores of the observation group decreased more significantly at the end of 4 weeks(P<0.05).After treatment,the levels of serum BDNF in the two groups were higher than those before treatment,and the levels of serum IL-1β,IL-6 and TNF-αwere lower than those before treatment.After 4 weeks of treatment,the increase of BDNF and the decrease of IL-1β,IL-6 and TNF-αin the observation group were more obvious than those in the control group(P<0.05).Conclusion:Acupuncture combined with high frequency repetitive transcranial magnetic stimulation can effectively improve the symptoms of depression after stroke,and the curative effect is better than that of single drug treatment.The mechanism may be related to the increase of serum BDNF level and the decrease of serum IL-1β,IL-6 and TNF-αlevels.