针刺治疗抑郁症及其对患者下丘脑-垂体-肾上腺轴的影响

目的:明确针刺治疗抑郁症的临床疗效,探讨针刺抗抑郁作用的神经内分泌学机制.方法:将60例抑郁症患者随机分为针刺组和药物治疗对照组.针刺组针刺内关、太冲、三阴交等穴治疗4周,对照组口服帕氟西汀治疗4周,在治疗前后分别作地塞米松抑制试验(DST),并检测血浆皮质醇和促肾上腺皮质激素(ACTH)的浓度.结果:针刺治疗抑郁症愈显率约73%,且不良反应小;两组血浆皮质醇和ACTH浓度,在治疗前后差异均有显著性意义(P<0.05),而且其含量随临床症状的缓解趋于正常.结论:针刺对抑郁症患者下丘脑-垂体-肾上腺(HPA)轴的影响是状态依赖性的,即随着针刺疗效的出现,患者的HPA轴功能也逐步恢复正常.

Effects of acupuncture on the hypothalamus-pituitary-adrenal axis in the patient of depression

ObjectiveTo observe the clinical effectiveness of ac upuncture in the patient of depression, and explore the neuroendocrine mechanism of acupuncture in anti-depression. Methods60 cases of depres sion were randomly divided into acupuncture group and medication group. They wer e respectively treated by acupuncture at Neiguan (PC 6), Taichong (LR 3), Sanyin jiao (SP 6), and oral western medicine for 4 weeks. Dexamethasone suppression te st (DST) before and after treatment were made and then the plasma cortisone and corticotropin (ACTH) were determined. ResultsThe markedly effe ctive rate was 73% in the acupuncture group with a less reverse effect; there we re significant differences before and after treatment in the plasma cortisone an d ACTH levels in the two groups (all P<0 05), and their levels tend to norm al with alleviation of clinical symptoms. ConclusionAcupunctur e has a better therapeutic effect on depression and can markedly decrease plasma corticol and ACTH levels in the patient of depression.