联合应用舍曲林与曲唑酮治疗抑郁症的效果比较

目的:对联合应用舍曲林与曲唑酮治疗抑郁症的效果进行观察研究。方法:资料选自2012年11月~2013年11月我院收治的抑郁症患者96例,将96例患者随机分为两组,对照组和研究组,对照组以舍曲林来进行治疗,研究组在对照组的治疗基础上联合曲唑酮进行治疗,并对两组临床资料进行回顾性分析。结果:经治疗后,研究组总有效率为93.75%,高于对照组总有效率75.00%,差异具有统计学意义(P<0.05)。研究组、对照组不良反应发生率分别为6.25%、12.50%,组间比较差异无统计学意义(P>0.05)。结论:采用舍曲林和曲唑酮对抑郁症患者进行治疗后,其临床疗效十分显著,可以有效改善患者抑郁、焦虑的症状,提升患者生活的质量,值得在临床中广泛推广应用。

抗抑郁治疗对脑卒中后抑郁患者预后影响的研究

目的了解抗抑郁治疗对脑卒中后抑郁(PSD)患者预后的影响。方法选择120例因脑卒中住院并发抑郁的患者为研究对象,并分为A、B、C三组,三组均给予常规治疗,B组在此基础上予氟西汀抗抑郁治疗,C组予氟西汀联合心理治疗的抗抑郁治疗。随访观察1年。结果①治疗后各时期HAMD评分A组>B组>C组;②治疗后各时期BI评定C组>B组>A组;③治疗6个月、1年神经功能恢复效果C组>B组>A组。结论抗抑郁治疗对于PSD患者的抑郁状态及神经功能的恢复均有积极的作用。

CLINICAL STUDY ON THE TREATMENT OF POST-STROKE DEPRESSION WITH ELECTROACUPUNCTURE OF “NIWAN BAZHEN” POINTS

Objective To observe the therapeutic effect of electroacupuncture （EA） of ＂Niwan Bazhen＂ points in the treatment of post-stroke depression. Methods A total of 66 post-stroke depression patients were randomized into treatment group （EA＋oral administration of Prozac-20, n =31 ） and control group （o- ral administration of Prozac-20, 20 mg/d, 28 days altogether, n =30）. For patients of treatment group, EA （2/100 Hz, a tolerable stimulation strength） was applied to ＂Niwan Bazhen＂ points [Baihui （百会 GV20）, etc. ] for 30 min, once daily, （except weekends） continuously for one month. Halmiton Rating Scale （HAMD） for Depression and Chinese Scale for Stroke （CSS） were used to evaluate the therapeutic effect. Results After the treatment, of the 30 and 31 cases in control and treatment groups, 4 and 6 were cured, 10 and 14 experienced marked improvement.in their symptoms, 6 and 7 had an improvement, 6 and 4 failed, with the cure＋ markedly effective rates being 46.7% and 64.5% respectively. The therapeutic effect of treatment group was significantly superior to that of control group （ P〈0.05）. The decreased values of both HAMD and C,,SS of treatment group were remarkably lower than those of control group （P〈0.01,0.05） . Conclusion EA of ＂Niwan Bazhen＂ points is an effective remedy for post-stroke depression.

RANDOMIZED CONTROL STUDY ON DEPRESSION INDUCED BY CHRONIC PAIN TREATED WITH ACUPUNCTURE

Objective To study and verify the efficacy of acupuncture on depression caused by chronic pain and to further analyze the advantages of acupuncture. Methods According to random number table, the cases were randomized into experimental group and western medicine group, treated with acupuncture and antidepression drug （deanxit） respectively. Hamilton Depressive Scale （HAMD） and Visual Analogue Scale （VAS） were adopted for the evaluation before treatment and in the 1, 2 and 4 weeks after treatment in two groups successively. Results ① Very significant differences had been achieved on the comparisons of HAMD, VAS and HAMD reducing rate before and after treatment in experimental group （P 〈 0.01）. Very significant differences had been achieved in the comparisons of HAMD, VAS and HAMD reducing rate before and after treatment in western medicine group （P 〈 0.01 ）. ③Significant differences in HAMD reducing rate^＊ and VAS score^＊ ＊ had been achieved in the comparison between experiment group and western medicine group 1 week after treatment （^＊ P〈0.01, ^＊ ＊ P〈0.05）. ④ The significant differences had not been received in HAMD, VAS score and HAMD reducing rate in 2 and 4 weeks after treatment in the comparison between experimental group and western medicine group （P 〉0.05）. ⑤ No any harmful effect happened in experimental group after treatment, but it happened in western medicine group. Conclusion Both acupuncture and deanxit have achieved the definite therapeutic effects on depression caused by chronic pain, with similar efficacy. But the effects of acupuncture are obtained more quickly. In comparison of western medicine, acupuncture has no side and harmful effect. Additionally, acupuncture applies the multi-targeting and holistic modulation to the whole body.

AN OBSERVATION OF THE THERAPEUTIC EFFECT OF WARMING NEEDLING TECHNIQUE ON JIAJI POINTS FOR THE TREATMENT OF DEPRESSION AND ITS INFLUENCE ON EEG-α WAVE IN PATIENTS

Objective To discuss the therapeutic effect and mechanism of warming needling technique for the treatment of depression. Methods A total of 60 patients with depression were randomly divided into treatment group and control group with 30 cases each. The treatment group was treated with warming needle technique on the Jiaji points of the heart, lung, liver, spleen and kidney, control group with Amitriptyline, HAMD scale and the qualitative change of EEG-α wave were observed before and after the treatment. Results The total effective rate of treatment group was 100%, much better than that of the control group with 80% (P<0.05); the HAMD scale of treatment group was better than that of control group (P<0.05); the comparison of the improvement of somatic symptoms between treatment group and control group was significant (P<0.05); the comparison of frequency and amplitude of EEG-α wave was significant (P<0.05), there was no toxic and side effect in the treatment group. Conclusion Warming needling technique for depression has better effect than Amitriptyline, and there was no toxic and side effect in the treatment group. Warming needle technique can effectively regulate the frequency and amplitude EEG-α wave, and acts to improve depressive condition.

Pharmacologic treatment of depression in patients with myocardial infarction

Depression is a common medical problem and is more prevalent among patients with coronary artery disease. Whether early detection and treatment of depression will enhance cardiovascular outcome is uncertain. Obviously, the safety and efficacy of the anti-depression drugs is an important link. This article reviews the patho-physiologic and behavioural links between depression and cardiovascular disease progression, the treatment of depression, and the potential benefits of anti-depressants in patients with coronary disease.

Progress of Animal Research on Electro-acupuncture Treatment for Depression

This paper summarized the Chinese literatures in the previous 5 years about the pre-clinical animal researches on the application of electro-acupuncture(EA) treatment for depression,searched in China National Knowledge Infrastructure(CNKI).The efficiency of EA treatment for depression and the mechanism of it were discussed,to shed light on new ideas and new fronts for the further research on depression in clinical or pre-clinical fields.

Levomilnacipran and vortioxetine:Review of new pharmacotherapies for major depressive disorder

Major depressive disorder(MDD) is a common psychiatric disorder with an estimated lifetime prevalence rate in the range of 13% to 16% in the United States population. Patients with MDD often have symptoms such as depressed mood, loss of interest or pleasure in usual activities, changes in eating or sleeping patterns, fatigue, difficulty concentrating and thoughts of suicide. Although many pharmacotherapy treatment options are available for MDD, antidepressants can oftencause adverse effects that could affect adherence to the medication. Additionally, it is estimated that MDD is unremitting in 15% of patients and 35% can have recurrent episodes. Given the high rate of recurrence and the adverse effects associated with existing medications, new treatment options for depression are needed. Both levomilnacipran and vortioxetine are new antidepressants that were approved by the food and drug administration in 2013 for the treatment of MDD in adults. Levomilnacipran is a serotonin norepinephrine reuptake inhibitor that was effective in several short term studies and sustained efficacy and tolerability was demonstrated in a 48-wk extension study. Vortioxetine is a multi-modal antidepressant and it is thought to work via inhibition of the serotonin(5-HT) transporter, 5-HT3 A, 5-HT7 and 5-HT1 D antagonist, a 5-HT1 B partial agonist, and a 5-HT1 A agonist. Vortioxetine was effective in the treatment of MDD in both short-term trials as well as in the prevention of relapse in a 24-36 wk trial. Sustained efficacy and tolerability was demonstrated in several long-term open-label trials. Further studies comparing levomilnacipran and vortioxetine to other currently available antidepressants are needed to establish its place in therapy.

A New Treatment of Depression for Drainage Network Extraction Based on DEM

Depressions in landscapes function as buffers for water and sediment. A landscape with depressions has less runoff, less erosion and more sedimentation than that without depressions. Sinks in digital elevation models （DEMs） can be considered the real features that represent depressions in actual landscapes or spurious features that result from errors in DEM creation. In many hydrological and erosion models, all sinks are considered as spurious features and, as a result, these models do not deal with the sinks that represent real depressions. Consequently, the surface runoff and erosion are overestimated due to removing the depressions. Aiming at this problem, this paper presents a new method, which deal with the sinks that represent real depressions. The drainage network is extracted without changing the original DEM. The method includes four steps： detecting pits, detecting depressions, merging depressions, and extracting drainage network. Because the elevations of grid cells are not changed, the method can also avoid producing new fiat areas, which are always produced by the conventional filling methods. The proposed method was applied to the Xihanshui River basin, the upper reach of the Jialingjiang River basin, China, to automatically extract the drainage network based on DEM. The extracted drainage network agrees well with the reality and can be used for further hydrologic analysis and erosion estimation.

High prevalence of post-partum depression in women with coeliac disease

AIM： To explore the prevalence of post-partumdepression （PPD） in coeliac disease （CD）. METHODS： we performed a case-control study evaluating the prevalence of PPD in CD patients on gluten-free diet （GFD） compared to that of healthy subjects experiencing a recent delivery. All participants were interviewed about menstrual features, modality and outcome of delivery and were evaluated for PPD by Edinburgh Postnatal Depression Scale （EPDS）. RESULTS： The study included 70 CD patients on GFD （group A） and 70 controls （group B）. PPD was present in 47.1% of CD women and in 14.3% of controls （P 〈 0.01; OR = 3.3）. Mean EPDS score was higher in CD compared to the controls （mean score： group A 9.9 ± 5.9; group B 6.7 ± 3.7; P 〈 0.01）. A signifcant association was observed between PPD and menstrual disorders in CD （69.7% vs 18.9%; P 〈 0.001; OR = 3.6）.CONCLUSION： PPD is frequent in CD women on GFD, particularly in those with previous menstrual disorders. we suggest screening for PPD in CD for early detection and treatment of this condition.

Pharmaceutical Care of the Patients Suffering from Depression

Depression is the most present mental disorders with a very expensive treatment costs. Due to the high prevalence of depression in Bosnia and Herzegovina and high work load of psychiatrists, patients that suffer from depression are often marginalised, stigmatised and inadequately treated. Therefore, a pharmacist can influence an adequate selection of a therapy through an interdisciplinary approach and pharmaceutical care and alos provide patient monitoring, counselling about side effects and interactions of the prescribed drugs, which will in the end improve the quality of life for patients that suffer from depression. The aim of this work was to establish the influence of pharmaceutical care on the outcome of the quality of life and the pharmacological treatment of patients suffering from depression. Results showed that the involvement of pharmacist in a multidisciplinary approach to the treatment of depression lead to improvement of the effect of therapy and increased quality of life.

Clinical observation of acupuncture combined with medication for mild-to-moderate depression

Objective:To discuss the clinical efficacy and plausible mechanism of Tiao Yang Qu Xie(regulating Yang to eliminate pathogenic factors)needling method plus paroxetine in treating mild-to-moderate depression.Methods:Sixty-six patients with mild-to-moderate depression were divided into an observation group and a control group using the random number table method,each consisting of 33 cases.Another 25 healthy subjects were recruited as a healthy group.The control group took oral paroxetine tablets for treatment,and the observation group received additional acupuncture treatment 3 times weekly.Both groups underwent 4-week treatment.Before treatment,after 2-week and 4-week treatment,and 2 weeks after treatment(follow-up),the patients were assessed using the Hamilton depression scale-17-item(HAMD-17),self-rating depression scale(SDS),self-rating anxiety scale(SAS),and traditional Chinese medicine(TCM)pattern element identification scale for depression.The two groups each randomly contributed 25 cases to detect the protein content of brain-derived neurotrophic factor(BDNF)before treatment and after 4-week treatment,and compared with the healthy group.Results:After 2-week treatment,the markedly effective and total effective rates were significantly higher in the observation group than in the control group(P<0.05);after 4-week treatment,the observation group significantly surpassed the control group in comparing the markedly effective rate(P<0.05).After 2 and 4 weeks of treatment and at the follow-up,the HAMD-17 total score and sleep disorder factor score were lower in the observation group than in the control group(P<0.05);the anxiety-somatic score was lower in the observation group than in the control group after 2-week treatment(P<0.05).After 2 and 4 weeks of treatment and at the follow-up,the observation group was lower than the control group in comparing the scores of SDS,SAS,and TCM pattern element identification scale for depression(P<0.05).After 4-week treatment,the observation group had an increased serum BDNF protein content,higher than that in the control group(P<0.05)and had no significant difference compared to the healthy group(P>0.05).Conclusion:Compared to the use of oral paroxetine alone,acupuncture plus paroxetine can produce more significant efficacy in treating mild-to-moderate depression and act faster in improving sleep disorder and anxiety-somatic symptoms;increasing the serum BDNF protein content may be a part of the mechanism underlying its antidepressant actions.

Acupuncture combined with ear point embedding for sleep disorder in depression

Objective To investigate clinical therapeutic effects of acupuncture combined with ear point embedding for treating sleep disorder in depression. Methods Seventy-six patients suffering from sleep disorder in depression were randomly divided into an observation group （39 cases） and a control group （37 cases）. In observation group, acupuncture at Baihui （百会 GV 20）, Shangxing （上星 GV 23）, Shenting （神庭 GV 24）, Fengchi （风池 GB 20） and Shenmen （神门 HT 7）, etc., which was combined with ear point embedding, and in control group, Fluoxetine Hydrochloride Dispersible tablet （Prozac） was orally given. Four weeks of treatments were given as a therapeutic course in both groups. Comparison of changes in scores of HAMD and PSQI was made between the two groups. Results After treatment, HAMD scores were obviously lowered in both groups （both P〈0.01）, and the reduction in HAMD score was more obvious in observation group than that in control group （P〈0.05）. After treatment, the reduction in PSQI score was more obvious in observation group （P〈0.01）, it was more significantly decreased than that in control group. Conclusion Acupuncture combined with ear point embedding provids remarkable therapeutic effects in treating sleep disorder in depression, which is superior to those provided by Fluoxetine Hydrochloride Dispersible Fablet orally given.

Effects on activities of daily life and quality of life of post-stroke depression treated with electroacupuncture at temple-three-needle

Objective To explore the better treatment of post-stroke depression. Methods Sixty cases of post-stroke depression ranged from mild to middle degree were randomly divided into comprehensive therapy group and medication group, 30 cases in each group. In comprehensive therapy group, electroacupuncture at temple-three-needle was mainly applied and Fluoxetine Hydrochloride capsule was taken by oral administration; in medication group, Fluoxetine Hydrochloride capsule was applied by oral administration. Functional Independent Measure （FIM） Scale and WHOQOL-BREF evaluation results before and after treatment were compared after 4 weeks treatment. Results Comparing with the FIM scores before treatment, the differences in the two groups were significant （both P0.01）, and the improvement in comprehensive therapy group （74.97±9.52） was superior to that in medication group （66.70±9.23） （P0.01）. Signif icant differences were presented statistically in comparison of index scores of WHOQOL-BREF before and after treatment in two groups （P0.05, P0.01）, and it in comprehensive therapy group was superior to that in medication group （P0.05, P0.01）. Conclusion Activities of daily life and quality of life of post-stroke depression can be significantly improved by electroacupuncture at temple-three-needle and oral administration of Fluoxetine Hydrochloride capsule.

Effect of acupuncture at Bǎihuì (百会GV 20) and Zúsānlǐ (足三里ST 36) on the level of serum inflammatory cytokines in patients with depression

Objective To investigate the immunologic mechanism of acupuncture at Bǎihuì（百 会 GV 20） and Zúsānlǐ（足三里 ST 36） for treatment of depression. Methods Eighty-four cases of depression patients were randomly divided into an electroacupuncture observation group（group A）, an electroacupuncture control group（group B） and a medication control group（group C）, 28 cases in each group. Bǎihuì（百会 GV 20） and Zúsānlǐ（足三里 ST 36） were used in the group A; Tàichōng （太冲 LR 3）, Sānyīnjiāo （三阴交 SP 6）, Nèiguān （内关 PC 6） and Shénmén （神门 HT 7） were used in the group B; and the group C was treated with oral administration of Fluoxetine. The scores of Hamilton Depression Scale （HAMD） were tested and the level of serum interleukin 1（IL-1β）, interleukin 6 （IL-6）, and tumor necrosis factor α （TNF-α） were measured by Enzyme Linked Immunosorbent Assay （ELISA）before and after treatment. Results Their scores of HAMD were obviously decreased after treatment in three groups（all P0.01）. In the group A, 2 cases were cured, 19 cases were markedly effective, 5 cases were effective and 2 cases were failed. In the group B, 16 cases were markedly effective, 12 cases were effective. While in the group C, 1 case was cured, 17 cases were markedly effective, 7 cases were effective and 3 cases were failed. The grade distribution of clinical effect showed that the effect of group A was better （P0.05）. The levels of serum IL-1β and IL-6 in the three groups were obviously decreased after treatment （P0.05, P0.01）, while there was no significant difference between the level of serum TNF-α before and after treatment. Conclusion The effect of electroacupuncture observation group is superior to those of electroacupuncture control group and medication control group.All of these three methods can clear the inflammatory cytokines such as IL-1β and IL-6 away and improve the symptoms of depression.

Exploration of the Clinical Regularity of Acupuncture-moxibustion Treatment for Depression

To review year 1956-2007 literature on acupuncture-moxibustion, explore point selection and methods for acupuncture-moxibustion treatment of depression. A comprehensive analysis was made by a method of metrological analysis according to the data from ＂China modem acupuncture-moxibustion information databank＂. The results show that Baihui （GV 20） and Neiguan （PC 6） were the points most frequently used. As an acupuncture-moxibustion treatment for depression, acupuncture ranked first. It is proposed to use Baihui （GV 20） and Neiguan （PC 6） as a basic prescription for acupuncture-moxibustion treatment of depression, other points can be selected according to the syndrome.

Meta analysis of the curative effect of acupuncture on post-stroke depression

OBJECTIVE:To systematically evaluate the curative effect of acupuncture on post-stroke depression(PSD).METHODS:The internet was used to retrieve the Wanfang Medical Data System,Chinese Periodical Net,the Weipu Information Resources System,PubMed and the Cochrane Library Database.Relevant articles,up to September 2010,were manually retrieved.These papers included studies that had performed random and semi-random control trials for the use of acupuncture to treat PSD.Fifteen random control tests involving 1096 patients were included in this study and individual cases,interventional measures and curative effects were extracted from this research.Grade methodological quality evaluation and meta-analysis were performed on these studies.RESULTS:Comparison between the acupuncture group and the Western medicine group for the curative rate on PSD revealed an OR of 1.48,95% CI = [1.11 1.97] and P=0.008.Comparison of obviously effective rate shows that OR=1.39,95% CI=[1.08 1.80] and P=0.01.Comparison of effective rate showsthatOR=0.83,95%CI=[0.631.09]andP=0.18.CONCLUSION:Comparison between the acupuncture group and Western medicine group in treating PSD revealed that there is a statistical difference in curative rate and remarkably effective rate,but no difference in effective rate.

Clinical treatment of depressive patients with Anshendingzhi decoction

OBJECTIVE: To determine the effects of Anshendingzhi decoction(ASDZD) on depression, to com-pare ASDZD with Danzhixiaoyao pill(DZXYP), and to provide evidence for the clinical treatment of depression with Traditional Chinese Medicine.METHODS: Seventy-eight patients with depression were enrolled from 2011 to 2013 in this double-blinded study. Patients were randomly divided into two groups: ASDZD(treatment group, n=39)and DZXYP(control group, n=39). Hamilton Depressive Scale and TCM Syndrome Differentiation Scale were used to assess depression and efficacy before treatment and 2, 4, and 6 weeks after treatment.The Treatment Emergent Symptoms Scale(TESS)was used to evaluate adverse reactions, observe,and record treatment outcomes.RESULTS: ASDZD was significantly more effective than DZXYP. There were significant differences between the two groups in terms of recovered patients, overall response rate, and TESS score(all P<0.05).CONCLUSION: ASDZD is an effective treatment for depression. ASDZD could improve clinical symptoms and warrants further clinical research and application.

Clinical Study on Treatment of Post-stroke Depression by Scalp Acupuncture plus Body Acupuncture

Objective： To explore the best method to treat post-stroke depression. Methods： 60 Cases of the patients with post-stroke depression were selected and divided randomly into the two groups, 30 cases in each group. The treatment group was treated by scalp acupuncture plus body acupuncture, and the control group was treated by oral administration of Fluoxetine. The therapeutic effects were assessed after 30 d of the treatments. Results： The total effective rate was 90.0% in the treatment group, with average effective time of 5 d, and was 80.0% in the control group, with average effective time of 15 d. The comparison of the total effective rates between the two groups was not significant statistically （P〉0.05）. But the comparison of the average effective time was significant statistically （P〈0.05）. Conclusion： The therapeutic effect is positive in the treatment of post-stroke depression by scalp acupuncture plus body acupuncture, similar to the therapeutic effect of Fluoxetine, but faster in the effective time.

Curative effect of acupuncture on quality of life in patient with depression： a clinical randomized single-blind placebo-controlled study

OBJECTIVE:To evaluate the effect of acupuncture on the quality of life in patients with depression by clinical randomized single-blind placebo-controlled study.METHODS:one hundred and sixty-three cases of depression according with the inclusion criteria were randomly divided into a group of acupuncture dredging liver and regulating flow of theosophy(group 1),a group of acupoint shallow stab(group 2)and a group of non-acupoint shallow stab(group 3)at 1∶1∶1 ratio,and treated with acu-puncture,moxibustion,and intradermal embedding of needle,twice a week,for a total of 12 weeks.Scale of Quality of Life(SF-36)was used to measure the scores at four different time points and evaluate the effect of acupuncture on the quality of life of the patients with depression.RESULTS:At each time point after treatment,in scores of the 8 items,physical function,physical role,bodily pain,general physical condition,energy,social function,emotional function and mental health there were statistically significant differences among the 3 groups(P<0.0125).CONCLUSION:Acupuncture can effectively improve the quality of life of patients with depression.