度洛西汀联合降糖治疗对糖尿病合并抑郁患者的疗效及对认知功能与皮质醇水平的影响
| 作者: |
1陈敏,
1宋清扬,
1戚欣生
1 北京市隆福医院老年病科，北京 100000 |
| 通讯: |
陈敏
Email: chenminapple@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2023.221732 |
摘要
目的：探讨度洛西汀联合降糖治疗对糖尿病合并抑郁患者的疗效及对认知功能与皮质醇水平的影响。方法：选取北京市隆福医院2020年4月至2021年4月确诊后治疗的60例糖尿病合并抑郁患者作为研究对象。患者均以二甲双胍作为降糖药治疗，联合度洛西汀作抗抑郁治疗。通过比较治疗前后认知功能与皮质醇水平分析治疗效果。结果：治疗后，患者5-羟色胺(5-hydroxytryptamine，5-HT)、去甲肾上腺素(norepinephrine，NE)水平较治疗前均显著提高(均P<0.001)；皮质醇水平较治疗前显著降低(P<0.001)；白细胞介素-6(interleukin-6，IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)水平较治疗前均显著降低(均P<0.001)。患者词语配对、视觉再现、逻辑记忆、图形重置、空间叠加评分均显著高于治疗前(均P<0.001)。患者焦虑情绪、抑郁情绪评分均显著降低(均P<0.001)。结论：临床治疗糖尿病合并抑郁患者选择二甲双胍、度洛西汀联合治疗，可改善神经营养因子、皮质醇及炎症因子水平，促进认知功能恢复，有效控制患者焦虑、抑郁情绪，具有显著的临床意义。
关键词：
糖尿病；抑郁症；度洛西汀；认知功能；皮质醇水平
Effect of duloxetine combined with hypoglycemic therapy on diabetic patients with depression and their cognitive function and cortisol level
CorrespondingAuthor: CHEN Min Email: chenminapple@126.com
DOI: 10.3978/j.issn.2095-6959.2023.221732
Abstract
Objective: To investigate the effect of duloxetine combined with hypoglycemic therapy on diabetic patients with depression and their cognitive function and cortisol level.
Methods: A total of 60 patients with diabetes and depression treated who were diagnosed and treated in the Beijing Longfu Hospital from April 2020 to April 2021 were selected as the research subject. Metformin was used as an antidiabetic drug and combined with duloxetine as an antidepressant treatment. The treatment effect was analyzed by comparing the cognitive function and cortisol levels before and after the treatment.
Results: After the treatment, the levels of 5-hydroxytryptamine (5-HT) and norepinephrine (NE) were significantly higher than those before the treatment (both P<0.001); the cortisol level was significantly lower than before treatment (P<0.001); and the levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were significantly decreased (both P<0.001). The scores of word pairing, visual representation, logical memory, graph resetting, and spatial superposition were significantly higher than those before the treatment (all P<0.001). The scores of anxiety and depression were significantly decreased (both P<0.001).
Conclusion: The combination of metformin and duloxetine for clinical treatment of diabetic patients with depression can change the levels of neurotrophic factors, cortisol, and inflammatory factors, promote the recovery of cognitive function, and effectively control the anxiety and depression of patients, which has a significant clinical significance.
Keywords：
diabetes; depression; duloxetine; cognitive function; cortisol level
Methods: A total of 60 patients with diabetes and depression treated who were diagnosed and treated in the Beijing Longfu Hospital from April 2020 to April 2021 were selected as the research subject. Metformin was used as an antidiabetic drug and combined with duloxetine as an antidepressant treatment. The treatment effect was analyzed by comparing the cognitive function and cortisol levels before and after the treatment.
Results: After the treatment, the levels of 5-hydroxytryptamine (5-HT) and norepinephrine (NE) were significantly higher than those before the treatment (both P<0.001); the cortisol level was significantly lower than before treatment (P<0.001); and the levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were significantly decreased (both P<0.001). The scores of word pairing, visual representation, logical memory, graph resetting, and spatial superposition were significantly higher than those before the treatment (all P<0.001). The scores of anxiety and depression were significantly decreased (both P<0.001).
Conclusion: The combination of metformin and duloxetine for clinical treatment of diabetic patients with depression can change the levels of neurotrophic factors, cortisol, and inflammatory factors, promote the recovery of cognitive function, and effectively control the anxiety and depression of patients, which has a significant clinical significance.