目的验证针刺对选择性五羟色胺再摄取抑制药（selective serotonin reuptake inhibitors,SSRI）的抗抑郁增效作用,并探讨针刺对外周血炎性细胞因子的影响。方法将61例抑郁症患者随机分成针刺组（n=30,接受针刺联合SSRI治疗）和对照组（n=31,仅接受SSRI治疗）。在基线、治疗3周末、治疗6周末进行汉密尔顿抑郁量表（HAMD）评定,并在治疗6周末进行Asberg抗抑郁药不良反应量表（SERS）评定。在基线、治疗6周末检测空腹静脉血血清IL-6、TNF-α的浓度,比较两组间的差异。结果 （1）两组的HAMD评分均随治疗时间推移而显著降低;在基线水平组间差异无统计学意义,但在治疗3周末及6周末时针刺组的HAMD评分均低于对照组（P均〈0.05）;（2）两组治疗前外周血IL-6、TNF-α浓度无统计学差异,治疗6周后两组IL-6、TNF-α浓度均显著降低且针刺组低于对照组（P均〈0.05）;（3）两组SERS评分无统计学差异。结论针刺对SSRI具有抗抑郁增效作用,且不增加药物不良反应,这一作用可能与针刺的抗炎作用有关。
Objective To verify the synergistic antidepressant effect of acupuncture for selective serotonin reuptake inhibitors（ SSRI） on major depressive disorder（ MDD）,and to explore its influence on peripheral inflammatory cytokines. Methods Sixty-one MDD patients were randomly divided into the trial group（ n = 30,treated with SSRI combined with acupuncture） and the control group（ n = 31,treated with SSRI alone）. The Hamilton Depression Rating Scale（ HAMD,24 items version） was used to estimate the severity of depression at baseline and after 3 weeks and 6 weeks of treatment,respectively. Asberg Rating Scale for Side Effects（ SERS） was employed to evaluate the severity of side effects at the end of 6 weeks of treatment. Peripheral concentrations of IL-6 and TNF-α were tested at baseline and towards the end of 6 weeks of treatment. Results（ 1） The HAMD scores in both groups decreased significantly over time. There was no significant difference between the two groups at baseline（ P〈0. 05）,but these scores were significantly lower after 3 and 6 weeks of treatment in the trial group than in the control group（ both P〈0. 05）.（ 2） There was no significant difference in peripheral concentrations of IL-6 or TNF-α at baseline（ both P〈0. 05）,but these concentrations significantly decreased after treatment in both groups,and they were lower in the trial group after 6 weeks of treatment（ P〈0. 05）.（ 3） There was no significant difference between the two groups in SERS scores. Conclusions Our result confirms the synergistic antidepressant effect of acupuncture for SSRI on MDD,and suggests that its antidepressant effect may be related to its anti-inflammatory effects.
Medical Journal of the Chinese People＇s Armed Police Forces
major depressive disorder
tumor necrosis factor α
selective serotonin reuptake inhibitors