温针灸联合药物治疗稳定型心绞痛合并抑郁的疗效观察及对血清resistin和adropin水平的影响

Efficacy observation of needle-warming moxibustion plus pharmaceutical treatment for stable angina pectoris coupled with depression and its effects on serum resistin and adropin levels

目的观察温针灸联合药物治疗稳定型心绞痛合并抑郁的临床疗效及对患者血清抵抗素(resistin)和能量平衡相关蛋白(adropin)水平的影响。方法将90例稳定型心绞痛合并抑郁患者随机分为对照组和观察组,每组45例。对照组在常规治疗基础上予盐酸舍曲林片口服,观察组在对照组基础上予温针灸治疗。比较两组治疗前后汉密尔顿抑郁量表-17(Hamilton depression scale-17,HAMD-17)评分、患者健康问卷-9(patient health questionnaire-9,PHQ-9)评分、心绞痛的发作频率、发作持续时间、疼痛程度、心肌缺血总负荷(total ischemia burden,TIB)及血清resistin和adropin水平。比较两组临床疗效。结果观察组总有效率高于对照组(P<0.05)。治疗后,两组HAMD-17和PHQ-9评分均降低(P<0.05),且观察组低于对照组(P<0.05);两组心绞痛发作频率、发作持续时间、疼痛程度均改善(P<0.05),且观察组优于对照组(P<0.05);两组TIB均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,对照组血清resistin水平无明显变化(P>0.05),血清adropin水平升高(P<0.05);观察组血清resistin水平降低(P<0.05),血清adropin水平升高(P<0.05),且均优于对照组(P<0.05)。结论在常规治疗基础上,温针灸联合口服盐酸舍曲林片治疗稳定型心绞痛合并抑郁的疗效优于单一口服盐酸舍曲林片治疗,可改善患者抑郁状态,缓解心绞痛症状,改善心肌缺血情况,可能与其调节血清resistin和adropin水平有关。

Objective To observe the clinical efficacy of needle-warming moxibustion plus pharmaceutical treatment in treating stable angina pectoris coupled with depression and its effects on the patient’s serum resistin and adropin levels.Method Ninety patients with stable angina pectoris and comorbid depression were randomized into a control group and an observation group,with 45 cases in each group.The control group received the conventional treatment plus oral administration of Sertraline hydrochloride tablets,in addition to which the observation group received needle-warming moxibustion.The following measurements were compared before and after the treatment:Hamilton depression scale-17(HAMD-17)score,patient health questionnaire-9(PHQ-9)score,angina attack frequency and duration,pain intensity,total ischemia burden(TIB),and serum resistin and adropin levels.The clinical efficacy was also compared between the two groups.Result The observation group had a higher total effective rate than the control group(P<0.05).After the treatment,the HAMD-17 and PHQ-9 scores dropped in both groups(P<0.05)and were lower in the observation group than in the control group(P<0.05);the angina attack frequency and duration,and pain intensity were improved in the two groups(P<0.05),and the observation group achieved better results than the control group(P<0.05);the TIB decreased in both groups(P<0.05)and was lower in the observation group than in the control group(P<0.05).After the intervention,the control group had no significant change in the serum resistin level(P>0.05)but an increased serum adropin level(P<0.05);in the observation group,the serum resistin level dropped(P<0.05),and the serum adropin level increased(P<0.05),which surpassed those in the control group(P<0.05).Conclusion Based on the conventional treatment in treating stable angina pectoris and comorbid depression,needle-warming moxibustion plus oral Sertraline hydrochloride tablets can produce more significant efficacy than taking Sertraline hydrochloride tablets alone;this combination method can improve depression,angina symptoms,and myocardial ischemia,which may be associated with regulating the serum resistin and adropin levels.