经颅微电流刺激对轻度抑郁症患者HPA、BDNF水平及临床症状的影响

目的探讨经颅微电流刺激治疗(CES)对轻度抑郁症患者下丘脑-垂体-肾上腺(HPA)轴和脑源性神经营养因子(BDNF)水平,以及临床症状的影响。方法将86名轻度抑郁症患者随机分为研究组和对照组。研究组采用CES方式治疗8周,对照组进行伪刺激。两组在治疗前和治疗后采集血样测定皮质醇(COR)、促肾上腺皮质激素(ACTH)和BDNF水平;应用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和失眠严重程度指数(ISI)评估临床症状变化。结果CES治疗后,研究组COR浓度、HAMA和ISI评分下降(t=-2.0538,-2.5512,-2.7228;P=0.0431,0.0125,0.0079),且明显低于对照组(t=2.3613,2.1188,3.2795;P=0.0205,0.0371,0.0015);其余各项指标变化无统计学意义(P﹥0.05)。对照组治疗前后各项指标变化无统计学意义(P>0.05)。结论CES治疗引起HPA轴相关激素的血液水平的改变,这可能是其改善焦虑和失眠症状机制之一,但对抑郁症状无明显效果。

Effects of cranial electrotherapy stimulation on the levels of HPA,BDNF and clinical symptoms in patients with mild depression Abstract

Objective To investigate the effects of Cranial electrotherapy stimulation(CES)on the levels of hypothalamic pituitary adrenal(HPA)axis,brain-derived neurotrophic factor and clinical symptoms in patients with mild depression.Method Eighty-six patients with mild depression were randomly assigned to either a Study group or a Control group.Blood samples were collected before and after treatment for 8 weeks to measure cortisol(COR),adrenocorticotropic hormone(ACTH)and BDNF.Clinical symptoms were assessed by Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)and insomnia severity index(ISI).Result After CES treatment,the level of COR,HAMA and ISI in the study group decreased(t=-2.0538,-2.5512,-2.7228;P=0.0431,0.0125,0.0079),which was significantly lower than that in the control group(t=2.3613,2.1188,3.2795;P=0.0205,0.0371,0.0015);the other indexes had no statistical significance(P>0.05).There was no statistical significance in the indexes of the control group before and after treatment(P>0.05).Conclusion The change of blood level of HPA axis related hormones caused by CES treatment may be one of the mechanisms to relieve anxiety and insomnia,but it has no obvious effect on depression.