| 刘丹,诸春明,赵彦,等.经颅直流电刺激联合耳针治疗老年抑郁症的临床效果观察及对病人认知功能、相关血清学指标的影响[J].安徽医药,2026,30(2):372-376. |
| 经颅直流电刺激联合耳针治疗老年抑郁症的临床效果观察及对病人认知功能、相关血清学指标的影响 |
| Clinical effect of transcranial direct current stimulation combined with auricular acupuncture on late-life depression and its effcets on cognitive function and phase the influence of related serological index |
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| DOI：10.3969/j.issn.1009-6469.2026.02.030 |
| 中文关键词: 抑郁症 认知功能障碍 经颅直流电刺激 耳针 脑源性神经营养因子 老年人 |
| 英文关键词: Depressive disorder Cognitive dysfunction Transcranial direct current stimulation Auricular acupuncture Brain-derived nerve growth factor Aged |
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| 中文摘要: |
| 目的探讨经颅直流电刺激疗法( tDCS)联合耳针治疗老年抑郁症( LLD)的临床效果，并观察其对病人认知功能、睡眠质量及血清学相关指标的影响。方法选取 2023年 1―10月在无锡市精神卫生中心就诊的 LLD病人 90例，按照随机数字表法分为 tDCS联合耳针治疗组( tDCS+耳针组)、耳针治疗组(耳针组)及 tDCS伪刺激组(伪刺激组)，每组 30例，分别于治疗前和治疗 10周后采用汉密尔顿抑郁量表( HAMD)、蒙特利尔认知评估量表( MoCA)、匹兹堡睡眠指数( PSQI)评价三组 LLD病人抑郁情绪、认知功能及睡眠情况，并观察治疗前后去甲肾上腺素( NE)、 5-羟色胺( 5-HT)、脑源性神经营养因子( BDNF)水平。结治疗前三组病人的各项指标比较均差异无统计学意义( P>0.05)，治疗 10周后，三组间病人的抑郁情绪、认知功能及睡眠情果况均较治疗前有改善( P<0.05)且相较于耳针组及伪刺激组， tDCS+耳针组对抑郁情绪［ HAMD(28.00±7.66)分比( 32.93±7.27)分、(33.70±8.45)分］、认知［MoCA(26.57±3.28)分比( 24.87±3.95)分、(24.07±3.97)分］的改善更明显，对睡眠情况［PSQI(10.40±2.46)分比( 11.13±2.87)分、(12.97±3.20)分］的改善也更明显( P<0.05)； tDCS+耳针组与耳针组均能改善病人睡眠质量( P<0.05)但二者之间差异无统计学意义( P>0.05)。治疗后 tDCS+耳针组 5-HT［(119.54±12.23)μg/L比( 102.11±10.24)μg/L］ 功能与 BDNF［( 2014±5.27)μg/L比( 13.37±5.14)μg/L］水平高于伪刺激组( P<0.05)，NE水平差异无统计学意义( P>0.05)。结论 tDCS联合耳针治疗对 LLD病人的抑郁情绪、认知功能及睡眠情况均有改善作用， tDCS及耳针治疗作为一种非创伤性的物理治.，疗值得在临床应用中进行推广。 |
| 英文摘要: |
| Objective To investigate the intervention of transcranial direct current stimulation (tDCS) combined with auricular acu-puncture in late-life depression, and to observe the effect of tDCS on cognitive function, sleep quality and serological related indicators. Methods A total of 60 late-life depression treated in Wuxi Mental Health Center from January to October 2023 were selected and di-vided into tDCS combined with auricular acupuncture, auricular acupuncture and pseudo-stimulation groups according to random num-ber table method. The Hamilton depression rating scale (HAMD), the Montreal cognitive assessment scale (MoCA) and Pittsburgh sleepqualtity index (PSQI) were used before and 10 weeks after treatment, to evaluate the depression, cognitive function and sleep status ofthe three groups, and the levels of norepinephrine (NE), 5-hydroxytryptophan (5-HT) and brain-derived nerve growth factor (BDNF) be-fore and after treatment were observed.Results There was no statistical significance in the comparison of various indicators among the three groups before treatment (P>0.05). After 10 weeks of treatment, depression, cognition and sleep were improved among the threegroups, the difference was statistically significant (P<0.05), and compared with ear acupuncture treatment group and pseudo-stimula-tion group, tDCS group combined with ear acupuncture treatment group had more obvious improvement on depression [HAMD (28.00±7.66) points vs. (32.93±7.27) points, (33.70±8.45) points], cognition [MoCA (26.57±3.28) points vs. (24.87±3.95) points, (24.07±3.97) points] and sleep quality [PSQI (10.40±2.46) points vs. (11.13±2.87) points, (12.97±3.20) points], the difference was statistically signifi-cant (P<0.05). Both tDCS group combined with ear acupuncture treatment and ear acupuncture treatment group could improve thesleep quality of patients, the difference was statistically significant (P<0.05), but there was no statistically significant difference be-tween them (P>0.05). Compared with the pseudo-stimulation group, the levels of 5-HT [(119.54±12.23) μg/L vs. (102.11±10.24) μg/L] and BDNF [(20.14±5.27) μg/L vs. (13.37±5.14) μg/L] in the tDCS group combined with ear acupuncture were significantly higher than those before treatment, the difference was statistically significant (P<0.05), and there was no statistically significant difference in NE level (P>0.05).Conclusions tDCS combined with auricular acupuncture can improve the depression, cognitive function and sleep sta-tus of late-life depression. tDCS and auricular acupuncture therapy as a non-traumatic physical therapy is worth promoting in clinical application. |
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