重复经颅磁刺激结合帕罗西汀治疗躯体形式障碍疗效观察  

Efficiency and safety of rTMS plus paroxetine in the treatment of somatoform disorder

作　　者：薛芬[1] 彭正午[1] 张华[1] 乔昱婷[1] 孙雯雯[1] 王莹[1] 谭庆荣[1] 

机构地区：[1]第四军医大学西京医院,陕西西安710032

出　　处：《精神医学杂志》2012年第6期414-416,共3页Journal of Psychiatry

基　　金：国家自然科学基金(编号:81171285)

摘　　要：目的观察重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)结合帕罗西汀治疗躯体形式障碍疗效及安全性。方法将50例躯体形式障碍患者随机给予帕罗西汀(25例)与rTMS结合帕罗西汀(25例)治疗,于治疗前及治疗后第2、3周末用汉密尔顿抑郁量表(HAMD)分评定疗效,并用不良反应量表(TESS)评定不良反应。结果帕罗西汀组显效率为68%,rTMS结合帕罗西汀组为88%,两组比较差异无统计学意义(P>0.05);治疗第2和3周末,两组患者的HAMD-17评分均较治疗前有显著性差异(均P<0.01),而且治疗第2周末和3周末rTMS结合帕罗西汀组评分均显著低于帕罗西汀组(均P<0.05);帕罗西汀组不良反应发生率为40%,rTMS结合帕罗西汀组为28%,两组比较差异无统计学意义(P>0.05)。结论 rTMS结合帕罗西汀治疗躯体形式障碍疗效优于单纯使用帕罗西汀,不良反应相似,而且起效更快。Objective To investigate the efficacy and safety plus paroxetine in the treatment of somatoform disorder. Methods of repetitive transcranial magnetic stimulation （rTMS） 50 patients with somatoform disorders were randomly divided into study group （25 cases ） treated with rTMS plus paroxetine and control group （25 cases） treated with paroxetine monotherapy for 3 weeks. Efficacy was evaluated by using Hamilton Depression Scale-17 item （HAMD-17） at the baseline and at the 2nd, 3rd weekend of the treatment. Treatment Emergent Symptom Scale （TESS） was used to evaluate the adverse reactions. Results There was no significant difference in effective rate between study group and control group （88% vs. 68%, P 〉0.05）. At the 2nd and 3rd weekend of the treatment, score of HAMD-17 in the two groups decreased significantly when compared with baseline （P 〈 0.01 ） , and score of HAMD-17 in study group was significantly lower than that in control group （P 〈 0. 05 ）. There was no significant difference in adverse reactions between study group and control group （28% vs. 40% ,P 〉 0.05 ）. Conclusion The efficacy of rTMS plus paroxetine is better than paroxetine monotherapy in the treatment of somatoform disorder. The adverse reactions is similar in the two therapeutics, but the rTMS plus paroxetine takes effect earlier.

关 键 词：RTMS 帕罗西汀 躯体形式障碍 

分 类 号：R749.7[医药卫生—神经病学与精神病学]