百会穴加强扬刺对中风后抑郁患者抗氧化酶及Nrf2/HO-1通路的影响

目的:探讨百会穴加强扬刺对中风后抑郁(PSD)患者抗氧化酶及Nrf2/HO-1通路的影响。方法:选取河北省沧州中西医结合医院收治的PSD患者100例为研究对象,随机分为西药治疗组(A组)和中西医结合治疗组(B组),各50例。两组患者均给予脑卒中的常规治疗,A组在常规治疗基础上给予盐酸氟西汀胶囊口服;B组在A组治疗方法基础上给予百会穴加强扬刺,均连续治疗20 d。比较两组的临床疗效及治疗前后的中医证候积分、HAMD和NIHSS量表评分以及血清神经递质、血清抗氧化酶和Nrf2、HO-1水平。结果:B组治疗后的显效率和有效率分别为68.0%(32/50)和92.0%(46/50),均显著优于A组的44.0%(22/50)和76.0%(38/50),组间比较差异均具有统计学意义(P<0.05)。与A组比较,B组治疗后的中医证候积分、HAMD和NIHSS量表评分均显著降低(P<0.05),5-HT、NE、SOD、GSH-PX及Nrf2、HO-1水平均显著升高(P<0.05)。结论:百会穴加强扬刺对PSD患者具有明显的治疗作用,能够明显改善患者的抑郁程度和神经功能缺损情况,该治疗作用可能与激活Nrf2/HO-1通路,增强机体抗氧化能力相关。

Effect of Intensified Centro-Square Needling DU20 on Anti-Oxidant Enzymes and Nrf2/HO-1 Pathway in Patients with Post-Stroke Depression

Objective:To investigate the effect of intensified centro-square needling Baihui(DU20)on anti-oxidant enzymes and Nrf2/HO-1 pathway in patients with post-stroke depression(PSD).Methods:A total of 100 PSD patients were randomly divided into the western medicine treatment group(group A)and the integrated TCM-WM treatment group(group B),with 50 cases in each group.Patients in both groups were given conventional treatment for stroke;on which basis,group A was given Fluoxetine Hydrochloride Capsules;group B was also treated with intensified centro-square needling DU20 on the treatment basis of group A.The treatment duration was continuous 20 days.The clinical efficacy,the scores of TCM syndrome,HAMD and NIHSS,as well as the serum levels of neurotransmitters,antioxidant enzymes,Nrf2 and HO-1 were compared between before and after the treatment in the two groups.Results:The marked effective rate and effective rate were 68.0%(32/50)and 92.0%(46/50)in group B,which were significantly higher than 44.0%(22/50)and 76.0%(38/50)in group A(P<0.05).Compared to those in group A,the decreases in the scores of TCM syndrome,HAMD and NIHSS were more significant(P<0.05),and the levels of 5-HT,NE,SOD,GSH-PX,Nrf2 and HO-1 were significantly higher in group B(P<0.05).Conclusion:Intensified centro-square needling DU20 has obvious therapeutic effect in patients with PSD.It can significantly reduce the degree of depression and neurological impairment in patients.The therapeutic effect may be related to the activation of Nrf2/HO-1 pathway and the enhancement of antioxidant capacity.