针刺联合舍曲林治疗肝豆状核变性相关抑郁障碍临床研究

Curative effect of acupuncture combined with sertraline in the treatment of depression related to Wilson’s disease

目的:评价针刺联合舍曲林治疗肝豆状核变性相关郁障碍的临床疗效。方法:将60例肝豆状核变性相关抑郁障碍患者随机分成对照组与观察组各30例,每组均接受基础排铜治疗,对照组服用舍曲林片,观察组在对照组的基础上给予针刺治疗,隔日1次,连续治疗28 d。观察两组患者治疗前及治疗14、28 d后汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)评分;观察患者治疗前后的血清5-羟色胺(5-HT)、去甲肾上腺素(NE)、多巴胺(DA)以及神经细胞因子脑源性神经营养因子(BDNF)和神经生长因子(NGF)水平变化。结果:观察组在治疗14 d后HAMD评分较对照组明显降低,在治疗后SDS评分较对照组明显降低,血清5-HT、NE、DA水平较对照组上升更为明显(P<0.05);对照组、观察组血清BDNF和NGF水平均升高(P<0.05),观察组患者血清BDNF和NGF水平较对照组升高明显(P<0.05)。对照组不良反应发生率为33.33%,观察组为13.33%,差异具有统计学意义(P<0.05)。结论:针刺联合舍曲林片治疗可提高肝豆状核变性相关抑郁障碍患者的临床疗效,且降低临床不良反应。

Objective:To evaluate the clinical efficacy of acupuncture combined with sertraline in the treatment of Wilson’s disease related depression.Methods:60 patients with Wilson’s disease related depression were randomly divided into the control group and the observation group,30 patients in each group.Each group received basic copper excretion treatment.The control group took sertraline tablets.The observation group received acupuncture treatment on the basis of the control group,once every other day,for 28 consecutive days.The scores of Hamilton Depression Rating Scale(HAMD)and Self Rating Depression Scale(SDS)were observed before treatment and 14 and 28 days after treatment;the changes of serum 5-hydroxytryptamine(5-HT),norepinephrine(NE),dopamine(DA),brain derived neurotrophic factor(BDNF)and nerve growth factor(NGF)were observed before and after treatment.Results:The HAMD score of the observation group was significantly lower than that of the control group after 14 days of treatment,the SDS score was significantly lower than that of the control group after treatment(at the end of 28 days),and the serum levels of 5-HT,NE,DA were significantly higher than those of the control group(P<0.05).The serum levels of BDNF and NGF were both higher in the control group and the observation group(P<0.05).The serum BDNF and NGF levels in the observation group were significantly higher than those in the control group(P<0.05).The incidence of adverse reactions was 33.33%in the control group and 13.33%in the observation group,with statistical significance(P<0.05).Conclusion:Acupuncture combined with sertraline tablets can improve the clinical efficacy of patients with Wilson’s disease related depression faster and more effectively,and reduce the adverse reactions of patients.