背景:抑郁症是一种常见的,慢性,和反复发作的情绪障碍已成为全球健康危害。盐酸氟西汀,一种常见的治疗方法,可以抑制5-羟色胺(5-HT)在突触前膜中的再循环;然而,单一药物的疗效不足。目前,轻度至中度抑郁症可以通过针刺鬼洞来治疗,但盐酸氟西汀联合治疗的临床疗效尚未得到充分报道。
目的:观察针刺鬼穴联合盐酸氟西汀治疗轻中度抑郁症的临床疗效。
方法:本研究纳入上海中西医结合医院收治的160例轻中度抑郁症患者,上海中医药大学附属,2022年1月至2023年6月。患者被分为单药组(盐酸氟西汀治疗,n=80)和联合组(盐酸氟西汀治疗联合鬼穴针刺,n=80)。记录治疗前症状,评估临床疗效和不良反应[Asberg抗抑郁药副反应量表(SERS)]。治疗前后抑郁[汉密尔顿抑郁量表(HAMD)-24],神经递质水平[5-HT,去甲肾上腺素(NE),多巴胺(DA)],氧化应激指标[超氧化物歧化酶(SOD),丙二醛(MDA)],和睡眠质量[匹兹堡睡眠质量指数(PSQI)]进行比较。
结果:联合组总有效率为97.50%,单药组总有效率为86.25%(P<0.05)。治疗2、4、6和8周后,HAMD,抑郁自评量表,与治疗前相比,联合组和单药组的SERS评分下降,联合组下降更显著(P<0.05)。经过8周的治疗,NE的水平,DA,5-HT,联合组和单药组的SOD增加,MDA水平降低;联合组的升高和降低更为显著(P<0.05)。联盟和单代理人组的PSQI得分下降,联合组下降更显著(P<0.05)。
结论:针刺鬼穴联合帕罗西汀片可以安全地改善抑郁症状和睡眠障碍,调节神经递质水平,减少轻度至中度抑郁症患者的应激反应。
BACKGROUND: Depression is a common, chronic, and recurrent mood disorder that has become a worldwide health hazard. Fluoxetine hydrochloride, a common treatment method, can inhibit 5-hydroxytryptamine (5-HT) recycling in the presynaptic membrane; however, the efficacy of a single drug is inadequate. At present, mild-to-moderate depression can be treated with acupuncture of ghost caves, but the clinical curative effect of combined therapy with fluoxetine hydrochloride has not been sufficiently reported.
OBJECTIVE: To evaluate the clinical effect of acupuncture at ghost points combined with fluoxetine hydrochloride in the treatment of mild-to-moderate depression.
METHODS: This retrospective study included 160 patients with mild-to-moderate depression who were admitted to Shanghai Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated to Shanghai University of Traditional Chinese Medicine, between January 2022 and June 2023. Patients were separated into a single-agent group (fluoxetine hydrochloride treatment, n = 80) and a coalition group (fluoxetine hydrochloride treatment combined with acupuncture at ghost points, n = 80). Pre-treatment symptoms were recorded, and the clinical curative effect and adverse reactions [Asberg Antidepressant Side Effects Scale (SERS)] were assessed. Depression before and after treatment [Hamilton Depression Scale (HAMD)-24], neurotransmitter levels [5-HT, norepinephrine (NE), dopamine (DA)], oxidative stress indicators [superoxide dismutase (SOD), malondialdehyde (MDA)], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were compared.
RESULTS: The total efficacy rate was 97.50% in the coalition group and 86.25% in the single-agent group (P < 0.05). After 2, 4, 6, and 8 wk of treatment, the HAMD, self-rating depression scale, and SERS scores of the coalition and single-agent groups decreased compared with pre-treatment, and the decrease was more significant in the coalition group (P < 0.05). After 8 wk of treatment, the levels of NE, DA, 5-HT, and SOD in the coalition and single-agent groups increased, while the levels of MDA decreased; the increases and decrease in the coalition group were more significant (P < 0.05). The PSQI scores of the coalition and single-agent groups decreased, and the decrease was more significant in the coalition group (P < 0.05).
CONCLUSIONS: Acupuncture at ghost points combined with paroxetine tablets can safely improve depressive symptoms and sleep disorders, regulate neurotransmitter levels, and reduce stress responses in patients with mild-to-moderate depression.