艾司西酞普兰联合电针治疗老年抑郁症的效果及对脑神经递质和近红外脑功能定量的影响

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摘要目的探讨艾司西酞普兰联合电针治疗老年抑郁症（GD）的效果及对脑神经递质和近红外脑功能定量的影响。方法选取2017年10月～2018年10月于内蒙古自治区精神卫生中心神经内科和精神科诊治的108例GD患者，按不同治疗方案分为两组，每组54例。对照组口服艾司西酞普兰治疗，观察组在此基础上行电针治疗，连续治疗4周。比较两组临床疗效、汉密尔顿抑郁量表（HAMD）评分、脑电超慢涨落分析、近红外脑功能定量。结果观察组治疗后的总有效率高于对照组，差异有统计学意义（P ＜ 0.05）。治疗后，两组HAMD评分均低于治疗前，且观察组低于对照组，差异有高度统计学意义（P ＜ 0.01）。治疗后，观察组多巴胺、去甲肾上腺素、5-羟色胺（5-HT）、乙酰胆碱受体（AchR）水平均高于治疗前及对照组，谷氨酸、γ-氨基丁酸水平均低于治疗前及对照组，对照组5-HT、AchR水平均高于治疗前，差异有统计学意义（P ＜ 0.05或P < 0.01）。治疗后，两组氧合血红蛋白（Oxy-Hb）均低于治疗前，且观察组低于对照组，差异有高度统计学意义（P ＜ 0.01）。结论艾司西酞普兰与电针联合治疗GD的效果显著，能有效改善脑内神经递质水平，调节前额叶皮质的Oxy-Hb水平，缓解抑郁症状，提高抑郁疗效。

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	田乐张慧如王毅王建俊倪晶晶景兰▲

关键词 ：老年抑郁症, 艾司西酞普兰, 电针, 脑电超慢涨落, 近红外脑功能定量

Abstract：Objective To explore the effect of Escitalopram combined with electroacupuncture in the treatment of geriatric depression (GD) and its effect on brain neurotransmitters and near infrared brain function quantification. Methods Total 108 GD patients diagnosed and treated in Neurology Department and Psychiatry Department of Inner Mongolia Mental Health Center from October 2017 to October 2018 were selected. According to different treatment schemes, they were divided into two groups, with 54 cases in each group. Control group was treated with Escitalopram and observation group was treated with electroacupuncture on this basis for 4 weeks. Clinical effect, HAMD score, EEG ultra-slow fluctuation analysis and NIR brain function quantification were compared between two groups. Results The total effective rate of observation group was higher than that of control group (P < 0.05). After treatment, HAMD scores of two groups were lower than before treatment, observation group was lower than control group, the differences were highly statistically significant (P < 0.01). After treatment, the levels of dopamine, noradrenaline, 5-hydroxytryptamine (5-HT) and acetylcholine receptor (AchR) in observation group were higher than those before treatment and those in control group, the levels of glutamate and γ-aminobutyric acid in observation group were lower than those before treatment and those in control group, the levels of 5-HT and AchR in control group were higher than those before treatment, the differences were statistically significant (P < 0.05 or P < 0.01). After treatment, oxyhemoglobin (Oxy-Hb) in both groups was lower than that before treatment, observation group was lower than control group, the differences were highly statistically significant (P < 0.01). Conclusion The combination of Escitalopram and electroacupuncture have significant effect in the treatment of GD patients, which can help to improve their neurotransmitter level and regulate the concentration of Oxy-Hb in the prefrontal cortex and alleviate depressive symptoms, thus improving the therapeutic effect of depression.

Key words： Geriatric depression Escitalopram Electroacupuncture EEG ultra-slow fluctuation Near infrared brain function quantification

基金资助:内蒙古自治区卫生和计划生育委员会科研计划项目（201703074）。

通讯作者: ▲通讯作者

引用本文:

田乐张慧如王毅王建俊倪晶晶景兰▲. 艾司西酞普兰联合电针治疗老年抑郁症的效果及对脑神经递质和近红外脑功能定量的影响[J]. 中国医药导报, 2020, 17(11): 69-72.
TIAN Le ZHANG Huiru WANG Yi WANG Jianjun NI Jingjing JING Lan▲. The effect of Escitalopram combined with electroacupuncture in the treatment of geriatric depression and its effect on brain neurotransmitter and near infrared brain function quantification. 中国医药导报, 2020, 17(11): 69-72.

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