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[经皮穴位电刺激对晚期妊娠抑郁症的影响及其对炎性细胞因子的作用]

[Effects of Transcutaneous Electrical Acupoint Stimulation for Depression in Late Pregnancy and Impacts on Inflammatory Cytokines].

作者信息

Chen Wei-Ye, Li Li, Wang Hui-Yuan, Jiang Nan

机构信息

Department of Anesthesiology, Tianhe Maternity and Child Health Hospital, Guangzhou 510620, China.

Department of Obstetrics, Tianhe Maternity and Child Health Hospital, Guangzhou 510620, China.

出版信息

Zhen Ci Yan Jiu. 2018 Jan 25;43(1):44-8. doi: 10.13702/j.1000-0607.160781.

Abstract

OBJECTIVE

To assess the safety and efficacy of transcutaneous electrical acupoint stimulation (TEAS) for depression in late pregnancy and impacts on inflammatory cytokines.

METHODS

A total of 150 pregnant women with depression in late pregnancy were randomized into a high intensity group (=52), a low intensity group (=49) and a control group (=49). TEAS was applied at bilateral Neiguan (PC 6) and Shenmen (HT 7) for 6 weeks. The intensities of TEAS in the high intensity group, the low intensity group and the control group were 10, 5 and 0 mA, respectively. During the process of TEAS, the blood pressure, pulse, uterine contraction and the fetal heart rate were recorded. Depression was evaluated by 24-item Hamilton depression scale (HAMD) before TEAS and after 2-week, 4-week, 6-week treatment. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-1 β (IL-1 β) and IL-6 were detected by enzyme-linked immunosorbent assay (ELISA) before and after 6-week treatment. Delivery outcomes were observed. The correlation was analyzed between HAMD difference value and the diffe-rence values of TNF-α, IL-1 β and IL-6, respectively.

RESULTS

The blood pressure, pulse and fetal heart rate had no statistical significance before and after treatment in the three groups (>0.05). The HAMD scores at all the time points were lower than that before treatment in the high intensity group (<0.05), which were lower compared with those in the low intensity group and the control group (<0.05). The HAMD score in the low intensity group decreased after 6-week treatment compared with that before treatment and was lower than that in the control group (<0.05). The serum levels of IL-1 β and IL-6 in the high intensity group decreased compared with those before treatment and were lower compared with those in the low intensity group and the control group after 6-week treatment (<0.05). There was no significant difference in the deliver outcomes among the three groups (>0.05). The variation of HAMD score did not have significant correlation with those of TNF-α, IL-1 β and IL-6 (>0.05).

CONCLUSION

TEAS is safe and effective for depression in late pregnancy and can regulate the serum levels of IL-1 β and IL-6 without influencing on delivery outcome.

摘要

目的

评估经皮穴位电刺激(TEAS)治疗晚期妊娠抑郁症的安全性和有效性以及对炎性细胞因子的影响。

方法

将150例晚期妊娠抑郁症孕妇随机分为高强度组(n=52)、低强度组(n=49)和对照组(n=49)。于双侧内关(PC 6)和神门(HT 7)应用TEAS,为期6周。高强度组、低强度组和对照组的TEAS强度分别为10、5和0 mA。在TEAS过程中,记录血压、脉搏、子宫收缩和胎儿心率。在TEAS治疗前及治疗2周、4周、6周后,采用24项汉密尔顿抑郁量表(HAMD)评估抑郁情况。在6周治疗前后,采用酶联免疫吸附测定(ELISA)法检测血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)和IL-6水平。观察分娩结局。分别分析HAMD差值与TNF-α、IL-1β和IL-6差值之间的相关性。

结果

三组治疗前后血压、脉搏和胎儿心率差异均无统计学意义(P>0.05)。高强度组各时间点的HAMD评分均低于治疗前(P<0.05),且低于低强度组和对照组(P<0.05)。低强度组治疗6周后的HAMD评分较治疗前降低,且低于对照组(P<0.05)。高强度组血清IL-1β和IL-6水平较治疗前降低,且在6周治疗后低于低强度组和对照组(P<0.05)。三组分娩结局差异无统计学意义(P>0.05)。HAMD评分变化与TNF-α、IL-1β和IL-6变化无显著相关性(P>0.05)。

结论

TEAS治疗晚期妊娠抑郁症安全有效,可调节血清IL-1β和IL-6水平,且不影响分娩结局。

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