氟西汀联合磁惊厥疗法治疗抑郁症患者的疗效及对血清5-羟色胺 多巴胺脑源性神经营养因子和炎症因子的影响

Therapeutic effect of fluoxetine combined with magnetic seizure therapy for depression patients and its influences on serum 5-hydroxytryptamine,dopamine,brain-derived neurotrophic factor and inflammatory factors

目的 探讨氟西汀联合磁惊厥疗法(MST)治疗抑郁症患者的疗效及对5-羟色胺(5-HT)、多巴胺(DA)、脑源性神经营养因子(BDNF)和炎症因子的影响。方法 将134例抑郁症患者按照随机数字表法分为对照组与研究组,各67例。对照组患者给予盐酸氟西汀胶囊治疗,研究组患者在对照组基础上联合MST治疗,两组患者均治疗4周。比较治疗4周末两组患者临床疗效,比较治疗前和治疗4周末两组患者汉密顿抑郁量表(HAMD-17)、汉密顿焦虑量表(HAMA)评分,5-HT、BDNF、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)水平,比较两组患者不良反应发生率。结果 研究组患者脱落3例,最终纳入64例,对照组脱落2例,最终纳入65例。研究组患者治疗总有效率高于对照组(P<0.05)。治疗4周末,两组患者HAMD-17、HAMA评分,IL-6、IL-1β水平均较治疗前下降,且研究组低于对照组(P<0.05或0.01)。治疗4周末,两组患者5-HT、DA、BDNF水平均较治疗前升高,且研究组高于对照组(P<0.01)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 氟西汀联合MST治疗抑郁症临床疗效显著,能够有效缓解患者抑郁、焦虑症状,能够有效上调5-HT、DA、BDNF水平,下调IL-6、IL-1β水平,值得推广应用。

Objective To explore the therapeutic effect of f luoxetine combined with magnetic seizure therapy(MST)for depression patients and its inf luences on 5-hydroxytryptamine(5-HT),dopamine(DA),brain-derived neurotrophic factor(BDNF)and inf lammatory factors.Methods A total of 134 depression patients were divided into control and research group according to random number table method,with 67 cases in each.Controls were treated with fluoxetine hydrochloride capsules,research group was plus the MST on the basis of controls,and both groups were treated for 4 weeks.After 4 week treatment clinical effects were compared between two groups,so were done the scores on the 17-item Hamilton Rating Scale for Depression(HAMD-17)and Hamilton Anxiety Scale(HAMA)and the levels of 5-HT,DA,BDNF,interleukin-6(IL-6),and IL-1βbefore treatment and after 4 week treatment,and so were done the incidences of adverse reactions.Results In research group 3 cases dropped out and 64 were included finally,in control group 2 cases dropped out and 65 were included finally.The total effective rate was higher in research than control group(P<0.05).After 4 week treatment the scores on HAMD-17 and HAMA and the levels of IL-6 and IL-1βin the two groups lowered compared with pre-treatment and those were lower in research than cont rol group(P<0.05 or 0.01).Af ter 4 week treatment the 5-HT,DA and BDNF level in the two groups elevated compared with pre-treatment and those were higher in research than control group(P<0.01).Intergroup difference in the incidences of adverse reactions wasn't statistically significant(P>0.05).Conclusion Fluoxetine combined with the MST has a significant clinical effect in the treatment of depression,can effectively alleviate the symptoms of depression and anxiety,increase the 5-HT,DA and BDNF level,lower the IL-6 and IL-1βlevel,and is worthy of popularization and application.