rTMS合并抗抑郁药对中风后抑郁的临床治疗  

Clinically Therapeutic Effect of rTMS with Anti-depressive Drugs on Primary PSD

作　　者：许可[1] 王顺先[1] 王晓明[1] 吴碧华[1] 郑霞清[1] 黄慧[1] 

机构地区：[1]川北医学院附属医院神经内科,四川南充637000

出　　处：《川北医学院学报》2006年第2期116-118,共3页Journal of North Sichuan Medical College

基　　金：四川大学华西医学院PSBH项目(川北医附院科经字[2004]4号)

摘　　要：目的探讨rTMS合并抗抑郁药对原发性中风后抑郁(post-stroke depression PSD)的疗效。方法研究我院神内科住院的脑卒中218例,其中急性期出现抑郁的患者(HAMD评分>17分)53例,入组45例随机分为对照组(抗抑郁药+心理治疗)15例,治疗组(rTMS+抗抑郁药+心理治疗)30例。统计出现PSD的时间、治疗前及治疗后1、3月的HAMD、SSS评分。抑郁疗效评定以HAMD减分率≥75%为痊愈,≥50%为显著进步,≥25%为进步,<25%为无效。③神经功能缺损康复以SSS评分减少91%-100%为完全恢复,减少46%-90%为显效,减少18%-45%为有效。结果①原发性PSD发生率为24.3%。②原发性PSD发生的时间中位数是3.5天。③治疗1月及3月后治疗组与对照组比较抗抑郁疗效和神经功能缺损康复疗效都有显著性差异(p<0.05)。结论rTMS有明显的治疗中风后抑郁、促进神经功能缺损康复的作用。Objective To investigate the effect of rTMS with antidepressive drugs on primary post-stroke depression （PSD） patients. Methods 218 cases in neurological department of our hospital were involved, of which 53 cases had HAMD scores higher than 17 points during the acute stage . Among the 53 cases,45 cases were observed and randomly divided into treatment group and control group. The treatment group（ n = 30） were dealt with rTMS, anti-depressive drugs and psychological treatment ,and the control group（ n = 15） were only dealt with anti-depressive drugs and psychological treatment . The occurring time of PSD, scores of HAMD and SSS before and after 1 month and 3 months treatment were analyzed. The treatment effect of depression was evaluated by the decrease rate of HAMD scores. If the rate was no less than 75% , full recovery was scaled, 50% significant progress, and 25% progress, while less than 25% was regarded as inefficiency. The neurological function deficiency rehabilitation was evaluated by the decrease of SSS scores. Decrease by 91% -100% was considered as completely recovery, 46% -90% as significantly effective, and 18% -45% as effective. Results The prevalence rate of primary PSD is 24.3%. The medium time of PSD occurring is 3.5 days. Significant differences in both anti-depression and neurological function defficency rehabilitation after 1 month treatment and 3 months treatment （p 〈 0. 05 ） have been found between treatment group and control one. Conclusion rTMS is prominent in treating PSD and in facilitating neurological function deficiency rehabilitation.

关 键 词：RTMS 抗抑郁药 中风后抑郁 临床治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]