| 陆源昕.醒神启闭针刺联合艾司西酞普兰治疗老年抑郁症临床观察[J].浙江中西医结合杂志,2023,33(7): |
| 醒神启闭针刺联合艾司西酞普兰治疗老年抑郁症临床观察 |
| Clinical observation of Xinshen Kaishu acupuncture combined with escitalopram in the treatment of senile depression |
| 投稿时间：2022-10-08 修订日期：2023-05-11 |
| DOI： |
| 中文关键词: 老年抑郁症 艾司西酞普兰 醒神启闭针刺 神经递质 应激反应 炎性因子 |
| 英文关键词:geriatric depression escitalopram acupuncture for Xingshen opening and closing neurotransmitter stress response inflammatory factors |
| 基金项目:2021年富阳区社会发展科技项目(2021SK008) |
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| 中文摘要: |
| 摘要：目的：探讨醒神启闭针刺联合艾司西酞普兰治疗老年抑郁症的临床疗效。方法：将60例老年抑郁症患者作为本次前瞻性研究的研究对象，病例收集时间为2020年6月至2022年1月，所有纳入的病例均根据纳入和排除标准进行筛选。将60例研究对象分为对照组和试验组，每组均为30例，分组方法采用随机数字表法。对照组患者服用草酸艾司西酞普兰片进行治疗，试验组采用草酸艾司西酞普兰片联合醒神启闭针刺法进行治疗，两组疗程均为12周，疗程结束后对比疗效。对比对照组和试验组治疗前后汉密尔顿抑郁量表（HAMD）评分、血清多巴胺（DA）、5-羟色胺（5-HT）、去甲肾上腺素（NE）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、C反应蛋白（CRP）、结合珠蛋白（Hp）和视黄醇结合蛋白4（RBP4）水平。结果：试验组治疗总有效率93.33%显著高于对照组70.00%（P＜0.05）；治疗后对照组和试验组相较于治疗前HAMD评分均降低（P＜0.05），且治疗后试验组相较于对照组HAMD评分明显更低（P＜0.05）；治疗后对照组和试验组相较于治疗前血清DA、5-HT和NE表达水平均升高（P＜0.05），且治疗后试验组相较于对照组血清DA、5-HT和NE表达水平明显更高（P＜0.05）；治疗后对照组和试验组相较于治疗前血清IL-6、IL-8、CRP表达水平均降低（P＜0.05），且治疗后试验组相较于对照组血清IL-6、IL-8、CRP表达水平明显更低（P＜0.05）；治疗后对照组和试验组相较于治疗前血清Hp、RBP4表达水平均降低（P＜0.05），且治疗后试验组相较于对照组血清Hp、RBP4表达水平明显更低（P＜0.05），差异具有统计学意义。结论：醒神启闭针刺联合艾司西酞普兰对老年抑郁症患者疗效较好，有助于增强单胺类神经递质的表达，并通过调节Hp、RBP4水平减少炎性因子的表达。 |
| 英文摘要: |
| Abstract: Objective:To explore the clinical efficacy of Xinshen Kaishu acupuncture combined with escitalopram in the treatment of senile depression.Methods:Sixty elderly patients with depression were selected as the research objects of this prospective study. The case collection time was from June 2020 to January 2022. All included cases were screened according to the inclusion and exclusion criteria. The 60 subjects were divided into a control group and an experimental group, with 30 cases in each group, and the grouping method was random number method. The patients in the control group were treated with escitalopram oxalate tablets, and the experimental group was treated with escitalopram oxalate tablets combined with acupuncture with Xinshen opening and closing. Comparison of Hamilton Depression Scale (HAMD) score, serum dopamine (DA), serotonin (5-HT), norepinephrine (NE), and interleukin-6 (IL-6) between the control group and the experimental group before and after the study , interleukin-8 (IL-8), C-reactive protein (CRP), haptoglobin (Hp) and retinol-binding protein 4 (RBP4) levels.Results: The total effective rate of treatment in the experimental group was 93.33%, which was significantly higher than that in the control group, which was 70.00% (P＜0.05). After the study, the HAMD scores of the control group and the experimental group were lower than those before the study (P＜0.05). The HAMD score was significantly lower in the control group (P＜0.05); the expression levels of DA, 5-HT and NE in the serum of the control group and the experimental group after the study were higher than those before the study (P＜0.05), and the experimental group after the study Compared with the control group, the serum levels of DA, 5-HT and NE were significantly higher (P＜0.05); the serum IL-6, IL-8, and CRP expression levels in the control group and the experimental group after the study were lower than those before the study (P＜0.05), and the serum IL-6, IL-8 and CRP expression levels of the experimental group were significantly lower than those of the control group after the study (P＜0.05); The expression levels of Hp and RBP4 were both decreased (P＜0.05), and the expression levels of serum Hp and RBP4 in the experimental group were significantly lower than those in the control group after the study (P＜0.05), and the difference was statistically significant. Conclusion:Xingshenkaishu acupuncture combined with escitalopram has good curative effect on elderly patients with depression, which helps to enhance the expression of monoamine neurotransmitters, and reduces the expression of inflammatory factors by regulating the levels of Hp and RBP4. |
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