摘要
目的探究重复经颅磁刺激联合舍曲林对产后抑郁症(PPD)患者抑郁症状及外周血miR-195、miR-124表达的影响。方法选取2017年6月—2019年10月杭州市第七人民医院PPD患者96例,按简单随机化法分为联合组、对照A组、对照B组,各32例。对照A组予以舍曲林(第1周50 mg/d,1周后增至100 mg/d),对照B组予以重复经颅磁刺激(1次/d,5次/周),联合组予以重复经颅磁刺激联合舍曲林,均治疗8周。比较3组疗效与治疗前后抑郁(EPDS)评分、生活质量(GQOLI-74)评分、血浆miR-195和miR-124表达、血清神经递质水平。结果联合组总有效率为93.75%,高于对照A组、对照B组(均P<0.05);治疗8周后联合组血浆miR-195表达水平(0.15±0.07)及血清NE、5-HT、E2水平[(23.05±4.11)、(239.57±12.24)、(176.98±14.13)ng/L]高于对照A组[0.11±0.05、(17.18±3.09)ng/L、(214.06±15.37)ng/L、(149.13±11.50)ng/L]、对照B组[0.09±0.06、(16.34±3.28)ng/L、(207.81±13.62)ng/L、(145.09±12.72)ng/L],血浆miR-124表达水平(0.11±0.05)及血清P水平[(21.87±3.16)ng/L]低于对照A组[0.17±0.06、(30.65±4.24)ng/L]、对照B组[0.20±0.09、(31.98±4.09)ng/L,均P<0.05];治疗8周后联合组GQOLI-74评分高于对照A组、B组,EPDS评分低于对照A组、B组(均P<0.05)。结论重复经颅磁刺激联合舍曲林治疗PPD患者,可调节血清神经递质、性激素水平及血浆miR-195、miR-124表达,降低EPDS评分,改善生活质量,疗效显著。
Objective To investigate the effects of repeated transcranial magnetic stimulation combined with sertraline on the depressive symptoms and expression of peripheral blood miR-195 and miR-124 in patients with postpartum depression(PPD).Methods A total of 96 patients with PPD were selected from June 2017 to October 2019 in Hangzhou Seventh People’s Hospital.They were divided into a combined group,control group A and control group B via a simple randomization method,32 cases in each group.Control group A was given sertraline(50 mg/d at 1 week,which was increased to 100 mg/d after 1 week),whereas control group B was given transcranial magnetic stimulation(1 time/d,5 times/week).The combined group was treated with repeated transcranial magnetic stimulation and sertraline.All patients were treated for 8 weeks.The efficacy and depression score(EPDS),quality of life(GQOLI-74)score,plasma miR-195 and miR-124 expressions and levels of serum neurotransmitters before and after treatment among the three groups were compared.Results The total effective rate of the combined group(93.75%)was significantly higher than that of control group A(71.88%)and control group B(68.75%,all P<0.05).After 8 weeks of treatment,the plasma miR-195 expression[(0.15±0.07)ng/L]and serum NE[(23.05±4.11)ng/L],5-HT[(239.57±12.24)ng/L],and E2[(176.98±14.13)ng/L]levels of the combined group were higher than those of control group A[0.11±0.05,(17.18±3.09)ng/L,(214.06±15.37)ng/L and(149.13±11.50)ng/L,respectively]and control group B[0.09±0.06,(16.34±3.28)ng/L,(207.81±13.62)ng/L and(145.09±12.72)ng/L,respectively].Moreover,plasma miR-124 expressions[(0.11±0.05)ng/L]and serum P levels[(21.87±3.16)ng/L]of the combined group were lower than those of control group A[0.17±0.06 and(30.65±4.24)ng/L,respectively]and control group B[0.20±0.09 and(31.98±4.09)ng/L,all P<0.05].After 8 weeks of treatment,the GQOLI-74 score of the combined group was higher than that of control groups A and B,and the EPDS score was lower than that of control groups A a
作者
刘文娟
宋明芬
王伟
刘学军
LIU Wen-juan;SONG Ming-fen;WANG Wei;LIU Xue-jun(Department of Clinical Psychology,Hangzhou Seventh Peoples Hospital,Hangzhou,Zhejiang 310013,China)
出处
《中华全科医学》
2021年第3期441-445,共5页
Chinese Journal of General Practice
基金
国家自然科学基金(81601183)。
