低频重复经颅磁刺激联合度洛西汀治疗抑郁障碍  

The effect of low frequency repetitive transcranial magnetic stimulation combined with duloxetine in treatment of depression

作　　者：张俊[1,2] 崔明[1,2] 吴延海[1,2] 宋红梅[1,2] 翟长平[1,2] 邓家佩[1,2] 王守虎[1,2] 骆祥芬[1,2] 王升[1] 

机构地区：[1]蚌埠医学院精神病学教研室,蚌埠233030 [2]安徽省荣军医院(蚌埠医学院附属安民医院,蚌埠市精神卫生中心)

出　　处：《中国神经精神疾病杂志》2015年第5期288-292,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：蚌埠医学院科研课题计划项目(编号:byky13128)

摘　　要：目的探讨低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,r TMS)联合度洛西汀治疗抑郁障碍的临床疗效和安全性。方法将69例抑郁障碍患者随机分为研究组(35例)和对照组(34例),研究组给予6周度洛西汀联合1 Hz r TMS治疗,r TMS作用于右侧前额叶背外侧皮质区域,对照组给予6周度洛西汀联合伪r TMS治疗。两组分别于治疗前和治疗2、4、6周采用汉密尔顿抑郁量表(Hamilton depression ratingscale-24,HAMD-24)评估抑郁症状,并按量表减分情况划分疗效等级;治疗2、4、6周采用治疗时出现的症状量表(treatment emergent symptom scale,TESS)评定不良反应。结果两组各脱落2例患者。HAMD评分经重复测量方差分析,时间主效应(P<0.001)、分组主效应(P=0.029)及时间与分组交互效应(P<0.001)均有统计学意义。疗效评估表明,治疗2、4、6周时研究组的临床疗效均优于对照组(P<0.001)。对照组1例患者因不能耐受胃肠道不良反应而退组,两组其他不良反应均较轻微,未出现严重不良反应。结论 1 Hz r TMS联合度洛西汀改善抑郁症状作用显著,疗效优于单一用药,且较为安全,值得临床推广应用。Objective To investigate the clinical efficacy and safety of repetitive transcranial magnetic stimulation combined with duloxetine in treatment of depression. Methods Sixty-nine cases of depression were randomly divided in-to study group （n=35 patients） and control group （n=34 patients）. The study group received duloxetine combined with 1Hz rTMS treatment on the right dorsolateral prefrontal cortex area for 6 weeks whereas the control group received duloxetine combined with pseudo-rTMS treatment for 6 weeks. The Hamilton Depression Rating Scale （HAMD-24） and Treatment Emergent Symptom Scale （TESS） were used to assess the clinical efficacy and the adverse reactions before, 2, 4 and 6 weeks after the treatment, respectively. Results Four patients （two from each group） dropped out of the study. The main effects of time （P〈0.001） and groups （P=0.029） were significant and so was the interactive effect of time and group （P〈0.001）. The clinical curative effect of the study group were significantly better compared with the control group at the 2, 4, 6 weeks following treatment （P〈0.001）. The adverse reactions were mild in these two groups. Conclusions The combi-nation of 1 Hz rTMS with duloxetine is superior to either medication alone for the treatment depression.

关 键 词：重复经颅磁刺激 度洛西汀 抑郁障碍 

分 类 号：R749.4[医药卫生—神经病学与精神病学]