运动对抑郁症症状、认知功能和γ-氨基丁酸影响的对照研究

目的 探讨运动行为干预对抑郁症症状和认知功能的影响，同时检测抑郁症患者体内γ-氨基丁酸(GABA)神经递质的变化，探讨运动干预改善抑郁症可能的生化机制。 方法 选取2018年11月—2019年4月安徽省精神卫生中心住院的65例成年抑郁症患者予以编号，然后采取抽签法抽取号码随机分组，分为干预组(35例)和对照组(30例)，5例干预组患者脱落。干预组运动方法为在跑步机上接受每周3~5次,每次35 min左右的慢跑有氧运动，运动时间为6周。运动前做10 min左右的热身运动，慢跑20 min左右，最后做5 min左右的缓慢运动。运用跑步机测量患者运动前后心率，使患者的最高训练心率能够控制在(220-年龄)×70%。干预组和对照组同时服用抗抑郁药物舍曲林(最大剂量为150 mg/d)治疗。采用汉密尔顿抑郁量表(HAMD)评分评估抑郁症症状，采用蒙特利尔认知评定量表(MoCA)评估认知功能，采用酶联免疫吸附试验法测量人体血浆中γ-氨基丁酸含量。2组间比较采用独立样本t检验，组内治疗前后比较采用配对样本t检验。 结果 对照组治疗前后HAMD分数差值为(-32.73±4.71)分，干预组治疗前后HAMD差值为(-24.23±8.95)分，运动结合抗抑郁药物治疗后抑郁症状显著改善(P<0.01)；对照组MoCA总分为(21.77±1.47)分，干预组MoCA总分为(25.23±1.16)分，运动结合抗抑郁药物治疗后认知功能显著改善(P<0.01)；对照组GABA浓度治疗前后差值为(0.32±1.54)mg/L，干预组GABA浓度治疗前后差值为(1.87±0.73)mg/L，运动结合抗抑郁药物治疗后GABA浓度明显上升(P<0.01)。 结论 运动干预可以改善抑郁症症状和认知功能，可以提高体内GABA含量。 

Control study of exercise' influence on depression's symptom,cognitive function and GABA

Objective To explore the effects of exercise on the symptoms, cognitive function and GABA in depression, as well as the possible biochemical mechanisms of exercise intervention in depression. Methods A total of 65 adult patients with depression from Anhui Mental Center were selected and numbered. Then the numbers were randomly divided by the lottery method. Patients (n=65) were divided into intervention group (n=35) and control group (n=30).5 patients in intervention group became detached. The intervention group took aerobic exercise on a treadmill about 35 minutes per day in a frequency of 3 to 5 times a week for 6 weeks. The whole exercise included a warm-up exercise for about 10 minutes before exercise, jogging for about 20 minutes, and a slow-down exercise for about 5 minutes. The heart rate of the patient was measured by using a treadmill before and after exercise, and the patient's highest training heart rate was controlled at (220-age)×70%. Besides, both of the intervention and the control group were treated with antidepressant sertraline (maximum dose of 150 mg/d). Depression symptoms were assessed by the Hamilton Depression Rating Scale. Cognitive function was assessed by the Montreal Cognitive Rating Scale. The GABA levels in human plasma were measured by enzyme-linked immunosorbent assay. The t-test of independent samples was used to compare sample data before and after treatment for the same group, while the t-test of paired samples were adopted for inter-group data. Different data were compared by the obtained means and variances. Results The difference of HAMD reduction scores were (-32.73±4.71) for the control group and (-24.23±8.95) for the intervention group. Total score of MoCA in the control group was (21.77±1.47), and in the intervention one was (25.23±1.16). The difference of GABA concentration in the control group before and after treatment was (0.32±1.54) mg/L, and in the intervention group was (1.87±0.73) mg/L. Exercise combined with antidepressant drugs significantly relieves depressive symptoms (P<0.01). Conclusion Exercise can relieve depressive symptoms and improve cognitive function of depression and increase the GABA levels in human plasma of depression.