认知行为治疗和西酞普兰治疗对抑郁症患者局部脑血流变化的影响  

Study of Regional Cerebral Blood Flow in the Patients with Depression Treated by Cognitive Behavioral Therapy or Citalopram

作　　者：倪爱华[1] 边艳珠[2] 靳春英[3] 郭树苗[1] 王秀芬[1] 

机构地区：[1]河北省人民医院心理科,河北省石家庄市050051 [2]河北省人民医院核医学科 [3]石家庄信息工程职业学院

出　　处：《中国全科医学》2007年第23期1944-1946,共3页Chinese General Practice

基　　金：河北省科技厅攻关课题(052761752)

摘　　要：目的探讨认知行为治疗和西酞普兰治疗对抑郁症患者局部脑血流变化的影响。方法45例抑郁症患者被随机分成认知行为治疗组和西酞普兰药物治疗组,认知行为治疗组22例,西酞普兰药物治疗23例。采用99mTc-双半胱乙酯(ECD)局部脑血流灌注SPECT显像结合感兴趣区(ROI)技术,对两组抑郁症患者治疗前后分别进行局部脑血流变化和汉密尔顿抑郁量表(HAMD)评分比较。结果治疗6周后,两组抑郁症状均有明显改善,但西酞普兰组HAMD得分与认知行为治疗组比较差别有显著性意义(P<0.05)。认知行为治疗和西酞普兰药物治疗均可增加右基底核的血流量,此外认知行为治疗组右边缘系统扣带回后部局部血流量增加,西酞普兰组右颞叶后部局部脑血流量增加。结论两种治疗方法治疗抑郁症均有效,治疗6周的疗效西酞普兰优于认知行为治疗。Objective To explore the changes of regional cerebral blood flow （rCBF） in patients with depression dis- order treated by Cogn/tive Behavioral Therapy or citalopram, Methods Totally 45 patients with depression disorder were divided as cognitive behavioral therapy group （ n = 22） and citalopram group （ n = 23 ） based on the way of treatment, single - photon - e- mission computer tomography （SPECT） rCBF imaging with Technetium99m -ethylcysteinated （99Tcm - ECD） combined with region of interesting （ROI） was performed for all patients. The rCBF distribution and Han airtight suppress quantity form （HAMD） scores was compared between pre - treatment and post - treatment in each group. Results After 6 week treatment, the depression in the two group was obviously improved; there were significant differences in HAMD scores between the two groups （ P 〈0. 05 ）, Both cognitive behavioral therapy and citalopram can increase rCBF of the right basal ganglion; besides the rCBF was increased in the cingulate gyrus of right limbic system in cognitive behavioral therapy group, and rCBF was increased in right temporal lobale in citalopram group. Conclusion Both cognitive behavioral therapy and citalopram treatment are effective for de- pression, however citalopram treatment is more effective after 4 week treatment.

关 键 词：抑郁症 认知行为治疗 西酞普兰 脑血流 

分 类 号：R749.42[医药卫生—神经病学与精神病学]