通元针法对肝气郁结型卒中后抑郁患者血清神经营养因子和下丘脑-垂体-肾上腺素轴功能的影响

Effect of Tongyuan Acupuncture Method on Serum Neurotrophic Factors and Hypothalamic-Pituitary-Adrenal Axis Function in Patients with Post Stroke Depression of Liver Qi Stagnation Type

目的:观察通元针法对肝气郁结型卒中后抑郁(PSD)患者血清神经营养因子和下丘脑-垂体-肾上腺素轴功能的影响。方法:按照随机数字表法,将2021年9月-2022年11月期间佛山市中医院收治的PSD患者102例分为对照组(n=51,接受常规治疗)和观察组(n=51,对照组的基础上接受通元针法治疗)。对比两组疗效、抑郁情况、血清神经营养因子和下丘脑-垂体-肾上腺素轴功能指标的变化情况。结果:与对照组相比,观察组的临床总有效率更高(P<0.05)。与对照组治疗4周后、治疗8周后相比,观察组汉密尔顿抑郁量表24项版本(HAMD-24)评分更低(P<0.05)。与对照组治疗8周后相比,观察组血清神经生长因子(NGF)、脑源性神经营养因子(BDNF)、胰岛素样生长因子-1(IGF-1)更高,血浆促肾上腺皮质激素(ACTH)、皮质醇(Cor)、促肾上腺皮质激素释放激素(CRH)更低(P<0.05)。结论:肝气郁结型PSD患者采用通元针法治疗,抑郁症状可得到显著缓解,能够调节血清神经营养因子,改善下丘脑-垂体-肾上腺素轴功能,具有较高的应用价值。

Objective:To observe the effect of Tongyuan acupuncture method on serum neurotrophic factors and hypothalamic-pituitary-adrenal axis function in patients with post stroke depression(PSD)of liver qi stagnation type.Methods:According to the random number table method,102 PSD patients admitted to Foshan Hospital of Traditional Chinese Medicine from September 2021 to November 2022 were divided into a control group(n=51,receiving routine treatment)and an observation group(n=receiving Tongyuan acupuncture on the basis of the control group).The efficacy,depression and changes of serum neurotrophic factors and hypothalamic-pituitary-adrenal axis function indexes were compared between two groups.Results:Compared with control group,the total clinical effective rate in observation group was higher(P<0.05).Compared with control group 4 weeks after treatment and 8 weeks after treatment,the Hamilton Depression Scale 24 item version(HAMD-24)score in observation group was lower(P<0.05).Compared with control group 8 weeks after treatment,the serum nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF)and insulin-like growth factor-1(IGF-1)in observation group were higher,and the plasma adrenocorticotropic hormone(ACTH),cortisol(Cor)and corticotropin releasing hormone(CRH)were lower(P<0.05).Conclusion:PSD patients of liver qi stagnation type are treat with Tongyuan acupuncture method,the depressive symptoms can be significantly alleviate,the serum neurotrophic factors can be regulate,and the function of hypothalamus-pituitary-adrenal axis can be improve,which has high application value.