Volume 19 Issue 2
Feb.  2021
Turn off MathJax
Article Contents
HAN Zhen-xiang, QI Li-li, HOU Zhen-zhen, ZHOU Yi-xin, LIU Ai-hua. Clinical effect of Xinshen Jieyu Decoction in the imbalance of Th17/Treg and Barthel index in the moderate or severe post-stroke depression patients[J]. Chinese Journal of General Practice, 2021, 19(2): 217-220. doi: 10.16766/j.cnki.issn.1674-4152.001771
Citation: HAN Zhen-xiang, QI Li-li, HOU Zhen-zhen, ZHOU Yi-xin, LIU Ai-hua. Clinical effect of Xinshen Jieyu Decoction in the imbalance of Th17/Treg and Barthel index in the moderate or severe post-stroke depression patients[J]. Chinese Journal of General Practice, 2021, 19(2): 217-220. doi: 10.16766/j.cnki.issn.1674-4152.001771

Clinical effect of Xinshen Jieyu Decoction in the imbalance of Th17/Treg and Barthel index in the moderate or severe post-stroke depression patients

doi: 10.16766/j.cnki.issn.1674-4152.001771
Funds:

 国中医药人教发[2017]29号

 ZY3-RCPY-1-1001

 PDZY-2019-0703

  • Received Date: 2020-03-28
    Available Online: 2022-02-19
  •   Objective  To investigate the clinical effect of Xinshen Jieyu Decoction in the moderate or severe post-stroke depression patients.  Methods  Ninety post-stroke depression patients were included in Seventh People's Hospital of Shanghai University of TCM, which was conducted from January 2014 to January 2018. The patients were randomized to receive Xinshen Jieyu Decoction combined with sertraline vs control sertraline group over 8 weeks. The HAMD was the primary outcome measure. As secondary aims, several biomarkers, such as BDNF, Treg and Th17 were investigated.  Results  The 2 group did not differ with the baseline severity of depression. Hamilton Depression scale (HAMD) score and Barthel Index in both groups were significantly improved (all P < 0.05). Meanwhile, HAMD score and Bathel Index were significantly more improved in the treatment group than in the control group after 4 weeks (all P < 0.05). The biomarkers, such as BDNF, Treg, Th17 and Treg/Th17 were significant difference before and after treatment (all P < 0.05) and these biomarkers were significantly better than those of the control group (all P < 0.05). BDNF level (27.31±5.20) and Treg level (6.52±0.93) in treatment group after treatment were higher than those in control group (23.03±5.62, 4.52±1.51). Th17 level (0.30±0.16) and Th17/Treg level (0.10±0.06) in treatment group after treatment were higher than those in control group (0.41±0.27, 0.16±0.07).  Conclusion  Imbalance of Th17/Treg may be a potent pathogenesis of PSD. Xinshen Jieyu Decoction combined with sertraline hydrochloride is more effective and safer than sertraline hydrochloride alone in the PSD treatment.

     

  • loading
  • [1]
    MITH K. Mental health: a world of depression[J]. Nature, 2014, 515(7526): 181. http://www.onacademic.com/detail/journal_1000039780816610_d177.html
    [2]
    BAYDYUK M, WU X S, HE L, et al. Brain-derived neurotrophic factor inhibits calcium channel activation, exocytosis, and endocytosis at a central nerve terminal[J]. J Neurosci, 2015, 35(11): 4676-4682. doi: 10.1523/JNEUROSCI.2695-14.2015
    [3]
    PENG S, LI W, LV L, et al. BDNF as a biomarker in diagnosis and evaluation of treatment for schizophrenia and depression[J]. Discov Med, 2018, 26(143): 127-136. http://www.ncbi.nlm.nih.gov/pubmed/30586536
    [4]
    李玉雄, 郭子运, 张雄新. 脑卒中后抑郁患者的炎性因子和脑源性神经营养因子水平变化及相关性分析[J]. 解放军医药杂志, 2018, 30(12): 101-104. doi: 10.3969/j.issn.2095-140X.2018.12.026
    [5]
    LIU X, KENKARE K, LI S, et al. Increased Th17/Treg ratio in poststroke fatigue[J]. Mediators Inflamm, 2015. DOI: 10.1155/2015/931398.
    [6]
    中华医学会精神病学分会. 中国精神障碍分类与诊断标准第三版(精神障碍分类)[J]. 中华精神科杂志, 2001, 34(3): 59-63. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA200103026.htm
    [7]
    KUCUKDEVECI A A, YAVUZER G, TENNANT A, et al. Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey[J]. Scand J Rehabil Med, 2000, 32(2): 87-92. doi: 10.1080/003655000750045604
    [8]
    HACKETT M L, PICKLES K. Part Ⅰ: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies[J]. Int J Stroke, 2014, 9(8): 1017-1025. doi: 10.1111/ijs.12357
    [9]
    KOOTKER J A, VAN MIERLO M L, HENDRIKS J C, et al. Risk factors for symptoms of depression and anxiety one year poststroke: a longitudinal study[J]. Arch Phys Med Rehabil, 2016, 97(6): 919-928. doi: 10.1016/j.apmr.2016.01.019
    [10]
    李雪, 郝铭, 罗有才, 等. 出血性卒中后抑郁患者认知功能与生活质量研究[J]. 陕西医学杂志, 2017, 46(11): 1545-1547. doi: 10.3969/j.issn.1000-7377.2017.11.018
    [11]
    崔燕, 魏峰, 阎文静, 等. 脑卒中后抑郁发病的影响因素[J]. 山东医药, 2017, 57(9): 89-91. doi: 10.3969/j.issn.1002-266X.2017.09.031
    [12]
    BEUREL E, LOWELL J A. Th17 cells in depression[J]. Brain Behav Immun, 2018, 69: 28-34. doi: 10.1016/j.bbi.2017.08.001
    [13]
    GALECKI P, KOWALCZYK M. Interleukin 17 and Treg-a common pathomechanism and a new target of therapy in rheumatic diseases and depression[J]. Reumatologia, 2018, 56(4): 201-202. doi: 10.5114/reum.2018.77969
    [14]
    DOLATI S, AHMADI M, KHALILI M, et al. Peripheral Th17/Treg imbalance in elderly patients with ischemic stroke[J]. Neurol Sci, 2018, 39(4): 647-654. doi: 10.1007/s10072-018-3250-4
    [15]
    KUTLUBAEV M A, HACKETT M L. Part Ⅱ: predictors of depression after stroke and impact of depression on stroke outcome: an updated systematic review of observational studies[J]. Int J Stroke, 2014, 9(8): 1026-1036. doi: 10.1111/ijs.12356
    [16]
    BARBI J, PARDOLL D, PAN F. Treg functional stability and its responsiveness to the microenvironment[J]. Immunol Rev, 2014, 259(1): 115-139. doi: 10.1111/imr.12172
    [17]
    LE JAN S, PLEE J, VALLERAND D, et al. Innate immune cell-produced IL-17 sustains inflammation in bullous pemphigoid[J]. J Invest Dermatol, 2014, 134(12): 2908-2917. doi: 10.1038/jid.2014.263
    [18]
    许文杰, 蒋瑞冲, 周一心, 等. 活血疏肝法治疗脑卒中后抑郁临床观察[J]. 陕西中医, 2019, 40(10): 1354-1356. doi: 10.3969/j.issn.1000-7369.2019.10.010
    [19]
    于晓雯, 李国强, 王中琳. 疏肝解郁法治疗卒中后抑郁的系统评价[J]. 中西医结合心脑血管病杂志, 2017, 15(24): 3103-3107. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY201724005.htm
    [20]
    张丹, 张春红, 马会靖, 等. 中医疗法预防脑卒中后抑郁有效性的系统评价[J]. 中国中医急症, 2017, 26(4): 577-580, 628. doi: 10.3969/j.issn.1004-745X.2017.04.004
    [21]
    周一心, 韩振翔. 醒神解郁汤治疗脑卒中后轻度抑郁30例疗效观察[J]. 新中医, 2015, 47(11): 35-37. https://www.cnki.com.cn/Article/CJFDTOTAL-REND201511019.htm
    [22]
    DE RYCK A, FRANSEN E, BROUNS R, et al. Psychosocial problems associated with depression at 18 months poststroke[J]. Int J Geriatr Psychiatry, 2014, 29(2): 144-152. doi: 10.1002/gps.3974
    [23]
    王思博, 王慧彬, 曲慧玲, 等. 卒中后抑郁的影响因素及其对生活质量的影响[J]. 中国医科大学学报, 2017, 46(9): 844-847. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYK201709017.htm
    [24]
    范真真, 李敏, 谢倩, 等. 高频重复经颅磁刺激联合高压氧治疗脑卒中后抑郁效果观察[J]. 山东医药, 2019, 59(16): 58-60. doi: 10.3969/j.issn.1002-266X.2019.16.016
    [25]
    CHAN A, YAN J, CSURHES P, et al. Circulating brain derived neurotrophic factor (BDNF) and frequency of BDNF positive T cells in peripheral blood in human ischemic stroke: effect on outcome[J]. J Neuroimmunol, 2015, 286: 42-47. doi: 10.1016/j.jneuroim.2015.06.013
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(4)

    Article Metrics

    Article views (183) PDF downloads(0) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return