阿戈美拉汀联合光照疗法治疗抑郁伴失眠的效果及对血清炎性因子的影响

Efficacy of Agomelatine Combined with Light Therapy in the Treatment of Depression Accompanied with Insomnia and the Effects on Serum Inflammatory Factors

摘要: 目的：观察阿戈美拉汀联合光照疗法在抑郁障碍伴失眠患者中的效果以及对血清炎性因子的影响。方法：采用随机数字表法将青岛市精神卫生中心2025年7月~2026年5月期间132例抑郁障碍伴失眠的患者分为对照组和实验组，均为66例。对照组仅给予阿戈美拉汀治疗；实验组在阿戈美拉汀基础上联合光照疗法。对比两个治疗组在治疗前和治疗8周末24项汉密尔顿抑郁量表(Hamilton Depression Rating Scale-24 item, HAMD-24)、汉密尔顿焦虑量表(Hamilton Anxiety Rating Scale, HAMA)、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index, PSQI)、治疗副反应量表(Treatment Emergent Symptom Scale, TESS)得分以及治疗前、治疗4周末、治疗8周末血清炎性因子白介素-6 (Interleukin-6, IL-6)、白介素-8 (Interleukin-8, IL-8)、肿瘤坏死因子-α (Tumor Necrosis Factor-α, TNF-α)水平。结果：治疗8周末两组HAMD-24、HAMA、PSQI得分较治疗前均降低(P < 0.05)，且实验组各项量表评分低于对照组(P < 0.05)；治疗8周末实验组血清IL-6水平低于对照组(P < 0.05)，且显著低于治疗前、治疗4周末水平(P < 0.05)；对照组全时点IL-6、两组IL-8与TNF-α组内对比均无统计学差异(P > 0.05)；治疗8周末，两组TESS得分无统计学差异(P > 0.05)。结论：阿戈美拉汀联合光照疗法可有效缓解抑郁障碍伴失眠患者焦虑抑郁情绪、改善睡眠、降低血清IL-6的水平，且患者耐受良好。

Abstract: Objective: To investigate the efficacy of agomelatine combined with light therapy in patients with depressive disorder accompanied with insomnia, and to explore the effect on serum inflammatory cytokines. Methods: A total of 132 patients with depressive disorder and insomnia admitted to Qingdao Mental Health Center from July 2025 to May 2026 were enrolled as study subjects. All patients were assigned to the control and experimental groups, with 66 patients in both group, using a random‑number table. The control group received agomelatine mnotherapy, while the experimental group was given additional light therapy on the basis of agomelatine treatment. Compare the Hamilton Depression Rating Scale-24 item (HAMD-24), Hamilton Anxiety Rating Scale (HAMA), Pittsburgh Sleep Quality Index (PSQI), Treatment Emergent Symptom Scale (TESS) scores, and detect the level of serum inflammatory cytokines (interleukin-6, interleukin-8, tumor necrosis factor-α) at baseline, week 4, and week 8 of the treatment. Results: After 8 weeks of treatment, the HAMD-24, HAMA and PSQI scores of both groups were significantly decreased compared with baseline (P < 0.05), and the scores of the above scales in the experimental group were significantly lower than those in the control group (P < 0.05). After 8 weeks of treatment, the serum IL-6 level in the experimental group was significantly lower than that in the control group (P < 0.05), and it was also significantly reduced compared with baseline and the level at week 4 of treatment (P < 0.05). There were no statistically significant differences in IL-8 and TNF-α levels in both groups, as well as serum IL-6 level in the control group before and after treatment (P > 0.05). After 8 weeks of treatment, there was no statistically significant difference in TESS scores between the two groups (P > 0.05). Conclusion: Agomelatine combined with bright light therapy can effectively relieve anxiety and depression, improve sleep quality, decrease the serum level of IL-6 and are well tolerated in patients with depressive disorder accompanied with insomnia.