改良中医情绪疗法联合帕罗西汀在抑郁症患者中的疗效观察及对外周血T淋巴细胞亚群的影响研究
|
摘要
目的:探讨改良中医情绪疗法联合帕罗西汀在抑郁症患者中的疗效观察及对外周血T淋巴细胞亚群的影响。方法:选择2014年5月～2017年4月以抑郁症收治的90例患者作为对象,按照随机数字表法分为对照组(n=45)和观察组(n=45)。对照组采用帕罗西汀治疗,观察组在对照组基础上联合改良中医情绪疗法治疗,两组均进行1个月治疗,治疗完毕后对患者效果进行评估。采用汉密尔顿抑郁量表(HAMD)对两组患者治疗前、治疗后1个月从认知障碍、睡眠障碍、躯体性焦虑、精神性焦虑及情绪进行评估;采用酶联免疫吸附实验测定两组患者治疗前、治疗后1个月白细胞介素-2(IL-2)和肿瘤坏死因子-α(TNF-α)水平;采用流式细胞仪测定两组患者治疗前、治疗后1个月CD3~+、CD4~+、CD8~+及CD4~+/CD8~+T细胞水平;记录并统计两组治疗后恶心、口干、便秘及头晕发生率,比较两组临床疗效及目标治疗对外周血T淋巴细胞水平的影响。结果:观察组治疗后1个月认知障碍、睡眠障碍、躯体性焦虑、精神性焦虑及情绪评分均低于对照组(P<0. 05); IL-2及TNF-α水平均低于对照组(P<0. 05); CD3~+、CD4~+、CD4~+/CD8~+T细胞水平均高于对照组(P<0. 05); CD8~+T细胞水平低于对照组(P<0. 05)。观察组与对照组治疗后比较,恶心、口干、便秘及头晕发生率差异无统计学意义(P>0. 05)。结论:将改良中医情绪疗法联合帕罗西汀用于抑郁症患者中有助于改善患者抑郁症状,降低炎症因子水平,能提高T淋巴细胞水平,值得推广。
Objective: To investigate the effect of improved traditional Chinese medicine( TCM) emotional therapy combined with paroxetine on patients with depression and T lymphocyte subsets in peripheral blood. Methods: Ninety patients admitted to depression from May 2014 to April 2017 were selected and divided into control group( n = 45) and observation group( n = 45) according to Random number table method. The control group was treated with paroxetine. The observation group was treated with modified TCM emotional therapy on the basis of the control group. Both groups were treated for 1 month. After the treatment,the patient's effect was evaluated. The Hamilton depression scale( HAMD) was used to evaluate cognitive impairment,sleep disturbance,somatic anxiety,mental anxiety and mood before treatment and 1 month later. The two groups were treated by enzyme-linked immunosorbent assay to measure the levels of interleukin-2( IL-2) and tumor necrosis factor-α( TNF-α) before treatment and 1 month later; CD3~+,CD4~+,CD8~+and CD4~+/CD8~+T cells were measured by flow cytometry before treatment and 1 month later. The incidence of nausea,dry mouth,constipation and dizziness after treatment were recorded and counted,and the clinical effects and T lymphocyte levels in peripheral blood were compared between the two groups. Results: The cognitive impairment,sleep disturbance,somatic anxiety,mental anxiety and emotional scores in the observation group were lower than those in the control group after treatment 1 month( P<0. 05). The levels of IL-2 and TNF-α in the observation group were lower than those in the control group after treatment 1 month( P < 0. 05). The levels of CD3~+,CD4~+and CD4~+/CD8~+T cells in the observation group were higher than those in the control group after treatment 1 month( P<0. 05). The level of CD8~+T cells in the observation group was lower than that in the control group( P<0. 05). There was no significant difference in the incidence of nausea,dry mouth,constipation and dizziness between the observation group and the control group( P >0. 05). Conclusion: The improved TCM emotional therapy combined with paroxetine in patients with depression can improve the patient's depressive symptoms,reduce the level of inflammatory factors,and increase the level of T lymphocytes,which is worthy of popularization and application.
Objective: To investigate the effect of improved traditional Chinese medicine( TCM) emotional therapy combined with paroxetine on patients with depression and T lymphocyte subsets in peripheral blood. Methods: Ninety patients admitted to depression from May 2014 to April 2017 were selected and divided into control group( n = 45) and observation group( n = 45) according to Random number table method. The control group was treated with paroxetine. The observation group was treated with modified TCM emotional therapy on the basis of the control group. Both groups were treated for 1 month. After the treatment,the patient's effect was evaluated. The Hamilton depression scale( HAMD) was used to evaluate cognitive impairment,sleep disturbance,somatic anxiety,mental anxiety and mood before treatment and 1 month later. The two groups were treated by enzyme-linked immunosorbent assay to measure the levels of interleukin-2( IL-2) and tumor necrosis factor-α( TNF-α) before treatment and 1 month later; CD3~+,CD4~+,CD8~+and CD4~+/CD8~+T cells were measured by flow cytometry before treatment and 1 month later. The incidence of nausea,dry mouth,constipation and dizziness after treatment were recorded and counted,and the clinical effects and T lymphocyte levels in peripheral blood were compared between the two groups. Results: The cognitive impairment,sleep disturbance,somatic anxiety,mental anxiety and emotional scores in the observation group were lower than those in the control group after treatment 1 month( P<0. 05). The levels of IL-2 and TNF-α in the observation group were lower than those in the control group after treatment 1 month( P < 0. 05). The levels of CD3~+,CD4~+and CD4~+/CD8~+T cells in the observation group were higher than those in the control group after treatment 1 month( P<0. 05). The level of CD8~+T cells in the observation group was lower than that in the control group( P<0. 05). There was no significant difference in the incidence of nausea,dry mouth,constipation and dizziness between the observation group and the control group( P >0. 05). Conclusion: The improved TCM emotional therapy combined with paroxetine in patients with depression can improve the patient's depressive symptoms,reduce the level of inflammatory factors,and increase the level of T lymphocytes,which is worthy of popularization and application.
引文
[1] Yang Y,Wang H,Hu J,et al. Lateral habenula in the pathophysiology of depression[J]. Curr Opin Neurobiol,2017,48:90-96.
[2]高丽娟,赵欣,李建国,等.重度抑郁症发病机制相关基因的生物信息学分析[J].生理学报,2018,70(4):361-368.Gao LJ,Zhao X,Li JG,et al. Bioinformatics analysis of genes involved in the pathogenesis of major depression[J]. Acta Physiologica Sinica,2018,70(4):361-368.
[3]乌兰图雅.应用帕罗西汀治疗抑郁症的疗效分析及安全性评估[J].基因组学与应用生物学,2017,36(4):1429-1434.Wulan Tuya. Efficacy analysis and safety evaluation of paroxetine in the treatment of depression[J]. Genomics Applied Biol,2017,36(4):1429-1434.
[4]孙振晓,刘化学.帕罗西汀致高催乳素血症泌乳1例报告[J].中国神经精神疾病杂志,2018,44(5):305-306.Sun ZX,Liu HX. Report of a case of lactation induced by highprolactinemia in paroxetine[J]. Chin J Neuropsychiatric Dis,2018,44(5):305-306.
[5]闫少校,郎俊莲.中医“情志相胜”心理治疗的优势、弊端与改进对策探讨[J].中医杂志,2012,53(4):294-296.Yan SX,Lang JL. TCM"emotional intelligence"advantages,disadvantages and improvement countermeasures of treatment[J]. J Trad Chin Med,2012,53(4):294-296.
[6]闫少校,吕梦涵,崔界锋.经穴情绪释放技术的机制与治疗程序探讨[J].国际中医中药杂志,2014,36(8):681-684.Yan SX,LüMH,Cui JF. Mechanism and treatment procedure of emotional release technique in acupoints[J]. Int J Trad Chin Med,2014,36(8):681-684.
[7]闫少校,曹延筠,崔界峰,等.改良中医情绪疗法的方法、接受性及对情绪影响的初步研究[J].时珍国医国药,2008,19(10):2405-2406.Yan SX,Cao YJ,Cui JF,et al. A preliminary study on the methods,receptivity and emotional effects of improving TCM emotional therapy[J]. Shizhen Guo Guoguo,2008,19(10):2405-2406.
[8]闫少校,赵霞,吕梦涵,等.改良中医情绪疗法配合抗抑郁药治疗抑郁症34例临床观察[J].中医杂志,2016,57(6):484-488.Yan SX,Zhao X,LüMH,et al. Clinical observation of 34 cases of depression treated with modified Chinese medicine emotional therapy combined with antidepressant[J]. J Trad Chin Med Pharmacy,2016,57(6):484-488.
[9]李红,毛叶萌.抑郁症发病机制的免疫学研究进展[J].中国免疫学杂志,2016,32(5):760-763.Li H,Mao YM. Progress in immunology research on the pathogenesis of depression[J]. Chin J Immunol,2016,32(5):760-763.
[10] Chen YF. Chinese classification of mental disorders(CCMD-3):towards integration in international classification[J].Psychopathology,2002,35(2-3):171-175.
[11] Liu CC,Wu YF,Feng GM,et al. Plasma-metabolite-biomarkers for the therapeutic response in depressed patients by the traditional Chinese medicine formula Xiaoyaosan:A(1)H NMRbased metabolomics approach[J]. J Affect Disord,2015,185:156-163.
[12]刘春林,阮克锋,高君伟,等.抑郁症的多机制发病[J].生理科学进展,2013,44(4):253-258.Liu CL,Ruan KF,Gao JW,et al. Multi-mechanism of depression[J]. Prog Physiol Sci,2013,44(4):253-258.
[13]邓朔,张鸿燕.抑郁症发病机制的神经免疫相关靶点研究现状[J].中国临床药理学杂志,2017,33(3):280-283.Deng S,Zhang HY. The nerve of depression pathogenesis current status of research on immune related targets[J]. Chin J Clin Pharmacol,2017,33(3):280-283.
[14]刘晓秋,白志军.中国抑郁症患者自杀危险因素的元分析[J].中国临床心理学杂志,2014,22(2):291-294.Liu XQ,Bai ZJ. Meta-analysis of suicide risk factors in Chinese patients with depression[J]. J Psychol,2014,22(2):291-294.
[15]周珊,黄民,王雪丁.选择性5-羟色胺再摄取抑制药的药物基因组学研究现状[J].中国临床药理学杂志,2018,34(2):188-192.Zhou S,Huang M,Wang XD. Current status of pharmacogenomics research on selective serotonin reuptake inhibitors[J]. Chin J Clin Pharmacol,2018,34(2):188-192.
[16]赵博,赵春妮.《黄帝内经》心理情绪疗法探析[J].中华中医药杂志,2009,24(1):19-21.Zhao B,Zhao CN. Analysis of psychological emotional therapy in Huang Di Nei Jing[J]. Chin J Trad Chin Med,2009,24(1):19-21.
[17]张立娟,张进强,贺慧,等.丹参抗抑郁的神经免疫机制研究探讨[J].世界科学技术-中医药现代化,2017,19(8):1289-1293.Zhang LJ,Zhang JQ,He H,et al. Study on the neuroimmune mechanism of anti-depression of Salvia miltiorrhiza[J]. World Sci Technol-Modern Trad Chin Med,2017,19(8):1289-1293.
[18]阳玉洁,卢祖能,王云甫. CD4+CD25+调节性T细胞与神经系统自身免疫性疾病研究进展[J].中国神经免疫学和神经病学杂志,2018,25(3):212-215.Yang YJ,Lu Z,Wang YQ. Progress in CD4 CD25 regulatory T cells and autoimmune diseases of the nervous system[J]. Chin J Neuroimmunol Neurol,2018,25(3):212-215.
[19] Guan SZ,Liu JW,Fang EF,et al. Chronic unpredictable mild stress impairs erythrocyte immune function and changes Tlymphocyte subsets in a rat model of stress-induced depression[J]. Environ Toxicol Pharmacol,2014,37(1):414-422.
[20] Wu W,Zheng YL,Tian LP,et al. Circulating T lymphocyte subsets,cytokines,and immune checkpoint inhibitors in patients with bipolarⅡor major depression:a preliminary study[J]. Sci Rep,2017,7:40530.
[21]陈磊,刘欢,陈建丽,等.基于神经内分泌激素和代谢组学关联分析的复方柴归方抗抑郁作用机制研究[J].中国中药杂志,2015,40(20):4080-4087.Chen L,Liu H,Chen JL,et al. Antidepressant mechanism of compound Chaiguifang based on neuroendocrine hormone and metabolomic association analysis[J]. Chin J Trad Chin Med,2015,40(20):4080-4087.
[2]高丽娟,赵欣,李建国,等.重度抑郁症发病机制相关基因的生物信息学分析[J].生理学报,2018,70(4):361-368.Gao LJ,Zhao X,Li JG,et al. Bioinformatics analysis of genes involved in the pathogenesis of major depression[J]. Acta Physiologica Sinica,2018,70(4):361-368.
[3]乌兰图雅.应用帕罗西汀治疗抑郁症的疗效分析及安全性评估[J].基因组学与应用生物学,2017,36(4):1429-1434.Wulan Tuya. Efficacy analysis and safety evaluation of paroxetine in the treatment of depression[J]. Genomics Applied Biol,2017,36(4):1429-1434.
[4]孙振晓,刘化学.帕罗西汀致高催乳素血症泌乳1例报告[J].中国神经精神疾病杂志,2018,44(5):305-306.Sun ZX,Liu HX. Report of a case of lactation induced by highprolactinemia in paroxetine[J]. Chin J Neuropsychiatric Dis,2018,44(5):305-306.
[5]闫少校,郎俊莲.中医“情志相胜”心理治疗的优势、弊端与改进对策探讨[J].中医杂志,2012,53(4):294-296.Yan SX,Lang JL. TCM"emotional intelligence"advantages,disadvantages and improvement countermeasures of treatment[J]. J Trad Chin Med,2012,53(4):294-296.
[6]闫少校,吕梦涵,崔界锋.经穴情绪释放技术的机制与治疗程序探讨[J].国际中医中药杂志,2014,36(8):681-684.Yan SX,LüMH,Cui JF. Mechanism and treatment procedure of emotional release technique in acupoints[J]. Int J Trad Chin Med,2014,36(8):681-684.
[7]闫少校,曹延筠,崔界峰,等.改良中医情绪疗法的方法、接受性及对情绪影响的初步研究[J].时珍国医国药,2008,19(10):2405-2406.Yan SX,Cao YJ,Cui JF,et al. A preliminary study on the methods,receptivity and emotional effects of improving TCM emotional therapy[J]. Shizhen Guo Guoguo,2008,19(10):2405-2406.
[8]闫少校,赵霞,吕梦涵,等.改良中医情绪疗法配合抗抑郁药治疗抑郁症34例临床观察[J].中医杂志,2016,57(6):484-488.Yan SX,Zhao X,LüMH,et al. Clinical observation of 34 cases of depression treated with modified Chinese medicine emotional therapy combined with antidepressant[J]. J Trad Chin Med Pharmacy,2016,57(6):484-488.
[9]李红,毛叶萌.抑郁症发病机制的免疫学研究进展[J].中国免疫学杂志,2016,32(5):760-763.Li H,Mao YM. Progress in immunology research on the pathogenesis of depression[J]. Chin J Immunol,2016,32(5):760-763.
[10] Chen YF. Chinese classification of mental disorders(CCMD-3):towards integration in international classification[J].Psychopathology,2002,35(2-3):171-175.
[11] Liu CC,Wu YF,Feng GM,et al. Plasma-metabolite-biomarkers for the therapeutic response in depressed patients by the traditional Chinese medicine formula Xiaoyaosan:A(1)H NMRbased metabolomics approach[J]. J Affect Disord,2015,185:156-163.
[12]刘春林,阮克锋,高君伟,等.抑郁症的多机制发病[J].生理科学进展,2013,44(4):253-258.Liu CL,Ruan KF,Gao JW,et al. Multi-mechanism of depression[J]. Prog Physiol Sci,2013,44(4):253-258.
[13]邓朔,张鸿燕.抑郁症发病机制的神经免疫相关靶点研究现状[J].中国临床药理学杂志,2017,33(3):280-283.Deng S,Zhang HY. The nerve of depression pathogenesis current status of research on immune related targets[J]. Chin J Clin Pharmacol,2017,33(3):280-283.
[14]刘晓秋,白志军.中国抑郁症患者自杀危险因素的元分析[J].中国临床心理学杂志,2014,22(2):291-294.Liu XQ,Bai ZJ. Meta-analysis of suicide risk factors in Chinese patients with depression[J]. J Psychol,2014,22(2):291-294.
[15]周珊,黄民,王雪丁.选择性5-羟色胺再摄取抑制药的药物基因组学研究现状[J].中国临床药理学杂志,2018,34(2):188-192.Zhou S,Huang M,Wang XD. Current status of pharmacogenomics research on selective serotonin reuptake inhibitors[J]. Chin J Clin Pharmacol,2018,34(2):188-192.
[16]赵博,赵春妮.《黄帝内经》心理情绪疗法探析[J].中华中医药杂志,2009,24(1):19-21.Zhao B,Zhao CN. Analysis of psychological emotional therapy in Huang Di Nei Jing[J]. Chin J Trad Chin Med,2009,24(1):19-21.
[17]张立娟,张进强,贺慧,等.丹参抗抑郁的神经免疫机制研究探讨[J].世界科学技术-中医药现代化,2017,19(8):1289-1293.Zhang LJ,Zhang JQ,He H,et al. Study on the neuroimmune mechanism of anti-depression of Salvia miltiorrhiza[J]. World Sci Technol-Modern Trad Chin Med,2017,19(8):1289-1293.
[18]阳玉洁,卢祖能,王云甫. CD4+CD25+调节性T细胞与神经系统自身免疫性疾病研究进展[J].中国神经免疫学和神经病学杂志,2018,25(3):212-215.Yang YJ,Lu Z,Wang YQ. Progress in CD4 CD25 regulatory T cells and autoimmune diseases of the nervous system[J]. Chin J Neuroimmunol Neurol,2018,25(3):212-215.
[19] Guan SZ,Liu JW,Fang EF,et al. Chronic unpredictable mild stress impairs erythrocyte immune function and changes Tlymphocyte subsets in a rat model of stress-induced depression[J]. Environ Toxicol Pharmacol,2014,37(1):414-422.
[20] Wu W,Zheng YL,Tian LP,et al. Circulating T lymphocyte subsets,cytokines,and immune checkpoint inhibitors in patients with bipolarⅡor major depression:a preliminary study[J]. Sci Rep,2017,7:40530.
[21]陈磊,刘欢,陈建丽,等.基于神经内分泌激素和代谢组学关联分析的复方柴归方抗抑郁作用机制研究[J].中国中药杂志,2015,40(20):4080-4087.Chen L,Liu H,Chen JL,et al. Antidepressant mechanism of compound Chaiguifang based on neuroendocrine hormone and metabolomic association analysis[J]. Chin J Trad Chin Med,2015,40(20):4080-4087.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |