山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (1): 65-70.doi: 10.6040/j.issn.1671-7554.0.2021.0508
赵璇1,李晓鹏2,李剑1,田彬1,王广君1
ZHAO Xuan1, LI Xiaopeng2, LI Jian1, TIAN Bin1, WANG Guangjun1
摘要: 目的 探讨磁珠耳穴贴压联合重复经颅磁刺激(rTMS)治疗脑卒中后抑郁患者的效果以及对血清中的瞬时受体电位通道1蛋白(TRPC1)、5-羟色胺(5-HT)、S100β蛋白水平的影响。 方法 选取脑卒中后抑郁的患者120例,采用随机数字表分为对照组(抗抑郁药物治疗)、rTMS组(抗抑郁药物+rTMS治疗)、耳穴组(抗抑郁药物+磁珠耳穴贴压治疗)、rTMS+耳穴组(抗抑郁药物+rTMS+磁珠耳穴贴压治疗)各30例,治疗疗程为4周;对比4组治疗前后的汉密尔顿抑郁量表(HAMD)评分、临床疗效和血清TRPC1、5-HT、S100β水平变化及不良反应。 结果 治疗前,对照组、rTMS组、耳穴组及rTMS+耳穴组的HAMD评分,差异无统计学意义(P>0.05);治疗后,rTMS+耳穴组的HAMD评分低于对照组、rTMS组及耳穴组(P<0.05); rTMS组、耳穴组的HAMD评分低于对照组(P<0.05);治疗前,对照组、rTMS组、耳穴组及rTMS+耳穴组的血清TRPC1、5-HT、S100β水平差异无统计学意义(P>0.05);治疗后,rTMS+耳穴组患者的血清S100β水平低于对照组、rTMS组及耳穴组(P<0.05),TRPC1、5-HT水平高于对照组、rTMS组、耳穴组(P<0.05);治疗后,rTMS组、耳穴组的血清S100β水平低于对照组(P<0.05),TRPC1、5-HT水平高于对照组(P<0.05);经过治疗,rTMS+耳穴组患者的总有效率高于对照组、rTMS组、耳穴组(P<0.05),rTMS组、耳穴组的总有效率明显高于对照组(P<0.05)。 结论 磁珠耳穴贴压联合rTMS治疗对于脑卒中后抑郁患者有着肯定的疗效,能有效调节血清TRPC1、5-HT及S100β水平,明显改善患者的抑郁症状。
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