米氮平与西酞普兰治疗双相抑郁的对照研究

目的:评价米氮平与西酞普兰治疗双相抑郁的疗效及安全性.方法:将符合中国精神障碍分类与诊断标准第3版双相抑郁诊断标准的64例患者随机分为两组,予米氮平(32例)及西酞普兰(32例)分别合并碳酸锂治疗,疗程为12周.采用汉密尔顿抑郁量表(HAMD)、躁狂量表(BRMS)、临床疗效总评量表(CGI)评定疗效,以治疗中出现的症状量表(TESS)评定不良反应.结果:治疗12周后,两组患者HAMD、CGI评分均显著减少(P＜0.05或P＜0.01),BRMS、TESS评分均无明显增加.两组间比较HAMD、CGI、BRMS、TESS评分差异无显著性(P＞0.05).结论:米氮平与西酞普兰治疗双相抑郁均有较好的疗效,不良反应较少,无诱发躁狂病例.     

帕罗西汀治疗2型糖尿病伴抑郁的研究

目的:探讨帕罗西汀对2型糖尿病伴发抑郁患者生活质量的影响.方法:对45例2型糖尿病伴发抑郁患者给予帕罗西汀治疗.疗程12周.治疗前后分别进行汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)及健康状况调查问卷(SF-36)评定.对照组50例为不伴抑郁的糖尿病患者进行SF-36评定.结果:帕罗西汀能明显改善治疗组抑郁、焦虑症状;治疗前2型糖尿病伴抑郁患者生活质量明显低于对照组.结论:帕罗西汀能明显改善2型糖尿病伴抑郁患者的生活质量及预后.     

抑郁症患者识别动态面部表情的执行功能研究

目的：通过威斯康星卡片分类测试（WCST）及动态面部表情识别任务,探讨抑郁症执行功能障碍特征及可能机制。方法：42例抑郁症患者及30名正常对照进行WCST测试;其中抑郁症患者19例及正常对照15名进行动态面部表情识别作业,记录反应时和正确率。结果：与正常对照组相比,抑郁症组存在不同程度WCST的操作损伤,动态面部表情的识别反应时延长,正确率降低。结论：抑郁症患者存在执行功能障碍,对区别不同面部表情的执行功能存在差异。     

抑郁症患者情绪词识别对照研究

目的：探讨抑郁症患者和正常对照者在进行情绪词识别时的差异。方法：34例在4周内未用药的抑郁症患者和32名正常对照者进行情绪词识别Go/No-Go测验。结果：抑郁症患者正情绪词识别时,反应时显著长于负性情绪词和正常对照组,遗漏数显著多于负性词和正常对照组。结论：抑郁症患者存在负性情绪偏好。     

The Alleviation of Gut Microbiota-Induced Depression and Colitis in Mice by Anti-Inflammatory Probiotics NK151, NK173, and NK175

Gut microbiota dysbiosis is strongly associated with psychiatric disorders and inflammatory bowel disease (IBD). Herein, we examined whether the fecal microbiota of IBD patients with depression (IBDD) and their gut microbiota culture (iGm) could cause depression and colitis in mice and anti-inflammatory probiotics could mitigate depression in iGm-transplanted or immobilization stress (IS)-exposed mice. Fecal microbiota transplantation (FMT) from IBDD patients, which exhibited Enterobacteriaceae-rich gut microbiota, and its gut microbiota culture (iGm) increased depression-like behaviors in mice. Their treatments heightened the blood lipopolysaccharide (LPS) level and colonic IL-1β and IL-6 expression. However, FMT from healthy volunteers or sulfasalazine treatment alleviated cGm-induced depressive-like behaviors and hippocampal and colonic inflammation in mice. Moreover, oral administration of Lactobacillus plantarum NK151, Bifidobacterium longum NK173, and Bifidobacterium bifidum NK175, which inhibited LPS-induced IL-6 expression in macrophages, alleviated cGm-induced depression-like behaviors, hippocampal NF-κB⁺Iba1⁺ cell numbers and IL-1β and IL-6 expression, blood LPS, IL-6, and creatinine levels, and colonic NF-κB⁺CD11c⁺ number and IL-1β and IL-6 expression in mice. Treatment with NK151, NK173, or NK175 mitigated immobilization stress (IS)-induced depressive-like behaviors, neuroinflammation, and gut inflammation in mice. NK151, NK173, or NK175 also decreased IS-induced blood LPS, IL-6, and creatinine levels. The transplantation of Enterobacteriaceae-rich gut microbiota can cause depression and colitis, as IS exposure, and anti-inflammatory NK151, NK173, and NK175, may alleviate stress-induced fatigue, depression, and colitis by regulating the expression of proinflammatory and anti-inflammatory cytokines through the suppression of gut bacterial LPS.     

基于中医情志理论探讨炎症性肠病患者生存质量及其影响因素

目的:分析炎症性肠病(IBD)患者的生存质量(HRQOL)及其影响因素,基于中医情志学说进行理论探讨。方法:应用一般资料调查表、焦虑自评量表(SAS)、抑郁自评量表(SDS)、一般健康状况问卷(SF-36)和炎症性肠病生存质量问卷(IBDQ),对90例炎症性肠病确诊患者进行问卷调查,分析受试者生存质量的主要影响因素。结果:受试者的平均焦虑、抑郁水平处于正常状态,生理机能、生理职能、精力、一般健康状况、情感职能、躯体疼痛、精神健康、社会功能共8项维度得分均低于常模水平,克罗恩病患者HRQOL优于溃疡性结肠炎患者(P0.05);影响IBD患者生存质量的主要因素是精神心理因素:焦虑和抑郁。结论:临床中医应关注IBD患者的焦虑和抑郁情绪,在中医情志理论的指导下,对不良情绪及早发现和干预,提高其生存质量,从而改善临床预后。     

益肾调肝针刺法治疗围绝经期抑郁症30例

目的:观察益肾调肝针刺法治疗围绝经期抑郁症的疗效,评价针刺治疗围绝经期抑郁症的临床价值。方法:将60例围绝经期抑郁症患者随机分成两组,针刺组30例,采用益肾调肝针刺法治疗;对照组30例,给予口服百忧解治疗。两组疗程均为4周。两组患者分别于治疗前后应用汉密尔顿抑郁量表(HAMD)进行评分,治疗后根据其减分率评定临床疗效,并观察不良反应。结果:两组患者治疗前后HAMD评分组内比较,差异具有显著统计学意义(均P<0.01)。治疗后两组间HAMD评分比较,差异具有统计学意义P<0.05。针刺组显效率为66.7%,总有效率为93.3%;对照组显效率为40.0%,总有效率为80.0%;治疗后两组疗效比较,差异具有统计学意义(P<0.05)。结论:益肾调肝针刺法可以显著改善围绝经期抑郁症患者的抑郁状态,其抑郁程度改善的疗效优于西药对照,且不良反应少,是一种安全、经济、有效的治疗方法。     

双针并刺治疗中风后上肢肌张力增高疗效观察

目的观察双针并刺治疗中风后上肢肌张力增高症状的疗效。方法将60例中风后上肢肌张力增高患者随机分成治疗组和对照组,每组30例。治疗组采取双针并刺患侧肢体拮抗1穴、拮抗2穴、拮抗3穴治疗,对照组给予常规针刺治疗。结果治疗组总有效率为76.7%,对照组为53.3%,两组总有效率比较差异具有统计学意义（P〈0.05）。结论双针并刺是一种治疗中风后上肢肌张力增高的有效方法。     

Association between Geriatric Nutritional Risk Index and Depression after Ischemic Stroke

Background: Malnutrition is associated with poor outcomes after stroke. However, the association between malnutrition and post-stroke depression (PSD) remains unelucidated. We aimed to explore the association between geriatric nutritional risk index (GNRI) and depression after ischemic stroke. Methods: In total, 344 patients with ischemic stroke were included in this analysis. The GNRI was calculated from serum albumin level, weight, and height at admission. Malnutrition was defined using the GNRI cutoff points. A lower GNRI score indicates an elevated nutritional risk. The outcome was depression, measured 14 days after ischemic stroke. Logistic regression models were used to estimate the association between the GNRI and risk of PSD. Results: A total of 22.9% developed PSD 14 days after stroke. The mean GNRI was 99.3 ± 6.0, and 53.8% of the patients had malnutrition. After adjusting for covariates, baseline malnutrition was not associated with risk of PSD (OR, 0.670; 95%CI, 0.370–1.213; p = 0.186). The restricted cubic splines revealed a U-shaped association between the GNRI and PSD. Compared to moderate GNRI, higher GNRI (OR, 2.368; 95%CI, 0.983–5.701; p = 0.085) or lower GNRI (OR, 2.226; 95%CI, 0.890–5.563; p = 0.087) did not significantly increase the risk of PSD. Conclusion: A low GNRI was not associated with an increased risk of depression after ischemic stroke.