针刺百会、足三里对抑郁症患者血清炎性细胞因子水平的影响

目的:探讨电针百会、足三里治疗抑郁症的免疫机制.方法:将84例患者随机分为电针观察组、电针对照组、药物对照组,每组28例.电针观察组穴取百会、足三里;电针对照组穴取太冲、三阴交、内关、神门;药物对照组给予百优解口服.在治疗前后分别用汉密尔顿抑郁量表(HAMD)评分,采用酶联免疫分析法(ELISA)检测患者血清中白细胞介素1(IL-1β)、白细胞介素6(IL-6)、肿瘤细胞坏死因子-а(TNF-а)的水平.结果:与治疗前比较,各组患者治疗后HAMD评分均显著降低(均P<0.01).电针观察组痊愈2例,显效19例,有效5例,无效2例;电针对照粗分别为0例、16例、12例、0例;药物对照组分别为l例、17例、7例、3例,临床疗效等级分布提示电针观察组有较好的疗效(P<0.05);3组患者血清IL-1β、IL-6水平均较治疗前显著降低(P<0.05,P<0.01);血清TNF-а有所降低,但无统计学意义.结论:电针观察组疗效优于电针对照组和药物对照组;3种治疗方法都能清除炎性细胞因子IL-1β及IL-6,从而改善抑郁症状.

Abstract：

Objective To investigate the immunologic mechanism of acupuncture at Bǎihuì(百会 GV 20) and Zúsānlǐ(足三里 ST 36) for treatment of depression. Methods Eighty-four cases of depression patients were randomly divided into an electroacupuncture observation group(group A), an electroacupuncture control group(group B) and a medication control group(group C), 28 cases in each and the group C was treated with oral administration of Fluoxetine. The scores of Hamilton Depression Scale (HAMD) were tested and the level of serum interleukin 1(IL-113), interleukin 6 (IL-6), and tumor necrosis factor a (TNF-a) were measured by Enzyme Linked Immunosorbent Assay (ELISA) before and after treatment. Results Their scores of HAMD were obviously decreased after treatment in three groups(all P<0.01). In the group A, 2 cases were cured, 19 cases were markedly effective, 5 cases were effective and 2 cases were failed. In the group B, 16 cases were markedly effective, 12 cases were effective. While in the group C, 1 case was cured, 17 cases were markedly effective, 7 cases were effective and 3 cases were failed. The grade distribution of clinical effect showed that the effect of group A was better (P<0.05). The levels of serum IL-1β and IL-6 in the three groups were obviously decreased after treatment (P<0.05, P<0.01 ), while there was no significant difference between the level group is superior to those of electroacupuncture control group and medication control group.All of these three methods can clear the inflammatory cytokines such as IL-1β and IL-6 away and improve the symptoms of depression.

Effect of acupuncture at Bǎihuì(百会 GV 20) and Zúsānlǐ(足三里 ST 36) on the level of serum inflammatory cytokines in patients with depression