Liu Yi, Feng Hui, Mao Hongjing, Mo Yali, Yin Yan, Liu Wenjuan, Song Mingfen, Wang Shengdong
Zhongguo Zhen Jiu. 2015 Jun;35(6):539-43.
To compare the difference in depression relief in the treatment of depressive disorder at the acute stage between the combined therapy of acupuncture and 5-HT (5-hydroxytryptamine) selective serotonini reuptake inhibitors (SSRIs) and the single application of SSRIs and explore the impact on the imbalance of 5-HT and TH1/TH2.
Ninety cases of depressive disorder at the acute stage were randomized into a combined therapy group and a medication group, 45 cases in each one. In the medication group, SSRIs were prescribed forl oral administration, once or twice a day, continuously for 4 weeks. In the combined therapy group, on the basis of treatment as the medication group, acupuncture was combined. The main acupoints were Baihui (GV 20), Yintang (GV 29), Shenting (GV 24), Fengchi (GB 20), Dazhui (GV 14) and Sishencong (EX-HN 1), once every two. days, continuously for 4 weeks. Before treatment, and after the 1st, 2nd and 4th weeks of treatment, the Hamilton depression scale (HAMD) was used to evaluate the depression severity. Separately, before and after the 4 weeks of treatment, the levels of serum 5-HT, interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-4 (IL-4) and interleukin-10 (IL-10) were determined and compared with those in 45 cases of the healthy group.
HAMD score was reduced in the 1st, 2nd and 4th weeks of treatment as compared with that before treatment in the combined therapy group (all P<0 01). HAMD score was reduced in the 2nd and 4th weeks of treatment as compared with that before treatment in the medication group (all P<0. 01). HAMD scores in the combined therapy group were lower than those in the medication group in the 1st, 2nd and 4th weeks of treatment (all P< 0. 01). Before treatment, in the combined therapy group and the medication group, the levels of serum 5-HT, IL-4 and IL-10 were all lower than those in the healthy group (all P<0. 01); the levels of IL-1β and IL-6 were higher than those in the healthy group (all P<0. 01). In the combined therapy group and the medication group, the levels of 5-HT, IL-4 and IL-10 in 4 weeks of treatment were all increased as compared with those before treatment (all P<0. 01), and the levels of IL-1β and IL-6 were lower than those before treatment (all P<0. 01). In the combined therapy group, the levels of IL-1β and IL-6 in 4 weeks of treatment were lower than those in the medication group, and the levels of 5-HT, IL-4 and IL-10 were higher than those in the medication group (P<0. 01, P< 0. 05).
The combined therapy of acupuncture and SSRIs achieves much quicker and more effective re-' sult for relieving depression in the patients of depressive disorder as compared with simple oral administration of' SSRIs, and much more contributes to adjust the imbalance of serum 5-HT and TH1/TH2.
比较针刺联合5-羟色胺（5-HT）选择性5-羟色胺再摄取抑制剂（SSRIs）与单纯应用SSRIs治疗急性期抑郁症缓解抑郁症状的差异，探讨其对5-HT及TH1/TH2失衡的影响。
将90例急性期抑郁症患者随机分为联合治疗组和药物治疗组，每组45例。药物治疗组口服SSRIs，每日1次或2次，连续服用4周。联合治疗组在药物治疗组治疗基础上加用针刺治疗，主穴取百会（GV20）、印堂（GV29）、神庭（GV24）、风池（GB20）、大椎（GV14）、四神聪（EX-HN1），隔日1次，连续治疗4周。治疗前及治疗第1、2、4周采用汉密尔顿抑郁量表（HAMD）评定抑郁严重程度。另于治疗4周前后分别测定血清5-HT、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、白细胞介素-4（IL-4）和白细胞介素-10（IL-10）水平，并与45例健康组比较。
联合治疗组治疗第1、2、4周HAMD评分较治疗前均降低（均P<0.01）。药物治疗组治疗第2、4周HAMD评分较治疗前降低（均P<0.01）。联合治疗组治疗第1、2、4周HAMD评分低于药物治疗组（均P<0.01）。治疗前，联合治疗组和药物治疗组血清5-HT、IL-4、IL-10水平均低于健康组（均P<0.01）；IL-1β、IL-6水平高于健康组（均P<0.01）。联合治疗组和药物治疗组治疗4周时5-HT、IL-4、IL-10水平较治疗前均升高（均P<0.01），IL-1β、IL-6水平低于治疗前（均P<0.01）。联合治疗组治疗4周时IL-1β、IL-6水平低于药物治疗组，5-HT、IL-4、IL-10水平高于药物治疗组（P<0.01，P<0.05）。
与单纯口服SSRIs相比，针刺联合SSRIs治疗抑郁症患者缓解抑郁症状起效更快、效果更佳，更有助于调节血清5-HT及TH1/TH2失衡。
