调督解郁法针刺治疗肿瘤相关性抑郁:随机对照研究

目的:观察调督解郁法针刺联合盐酸舍曲林片与单纯盐酸舍曲林片对肿瘤相关性抑郁患者的影响,探讨其作用机制。方法:将120例肿瘤相关性抑郁患者随机分为观察组和对照组,各60例。在肿瘤内科常规治疗基础上,对照组予盐酸舍曲林片口服,每次50 mg,每日1次;观察组在对照组治疗基础上加用调督解郁法针刺治疗,穴取中脘、百会、神庭、心俞、肝俞、脾俞、神门、太冲、太溪,治疗20~40 min,每日1次,每周5次,均治疗6周。观察治疗前,治疗2、4、6周后两组患者抑郁自评量表(SDS)和汉密尔顿抑郁量表(HAMD)评分及治疗前后外周血血清白细胞介素(IL)-2、IL-4、IL-10、γ干扰素(IFN-γ)、转化生长因子β(TGF-β)水平。结果:治疗2、4、6周后,两组患者SDS、HAMD评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,两组患者外周血血清IL-4、IL-10、TGF-β水平均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);外周血血清IL-2、IFN-γ水平均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。结论:调督解郁法针刺联合盐酸舍曲林片可有效缓解肿瘤相关性抑郁患者的抑郁状态,疗效优于单纯盐酸舍曲林片,其作用机制可能与调节机体免疫相关细胞因子表达有关。

Effect of Tiaodu Jieyu acupuncture on cancer-related depression:a randomized controlled trial

Objective To observe the effect of Tiaodu Jieyu acupuncture combined with sertraline hydrochloride and sertraline hydrochloride alone on cancer-related depression(CRD),and to explore its action mechanism.Methods A total of 120 patients with CRD were randomly divided into an observation group and a control group,60 cases in each group.Based on the routine treatment of oncology,the patients in the control group were treated with sertraline hydrochloride tablets,50 mg per time,once a day,and the patients in the observation group were additionally treated with Tiaodu Jieyu acupuncture at Zhongwan(CV 12),Baihui(GV 20),Shenting(GV 24),Xinshu(BL 15),Ganshu(BL 18),Pishu(BL 20),Shenmen(HT 7),Taichong(LR 3),Taixi(KI 3),20 to 40 min per time,once a day,5 times a week.Both the treatments were given for 6 weeks.The self-rating depression scale(SDS)score,Hamilton depression scale(HAMD)score before treatment and after 2-week,4-week and 6-week treatment as well as the levels of serum interleukin(IL)-2,IL-4,IL-10,interferon gamma(IFN-γ)and transforming growth factorβ(TGF-β)before and after treatment were observed in the two groups.Results Compared before treatment,the SDS scores and HAMD scores in the two groups were reduced after 2-week,4-week and 6-week treatment(P<0.05),and SDS scores and HAMD scores in the observation group were lower than those in the control group(P<0.05).Compared before treatment,the serum levels of IL-4,IL-10 and TGF-βin the two groups after treatment were reduced(P<0.05),and those in the observation group were lower than the control group(P<0.05).Compared before treatment,the serum levels of IL-2 and IFN-γin the two groups after treatment were increased(P<0.05),and those in the observation group were higher than the control group(P<0.05).Conclusion Tiaodu Jieyu acupuncture combined with sertraline hydrochloride tablets could effectively relieve the depression state in patients with CRD,and the curative effect is better than sertraline hydrochloride tablets alone.The mechanism may be related to regulating the expression of immune-related cytokines.