重复经颅磁刺激联合度洛西汀治疗广泛性焦虑障碍患者的临床价值  

Clinical effects of repetitive transcranial magnetic stimulation combined with dutoxetine on patients with generalized anxiety disorder

作　　者：任季冬 阮洪梅[1] 胡宇[1] 

机构地区：[1]攀枝花市第三人民医院精神科,四川攀枝花617061

出　　处：《海南医学院学报》2016年第5期477-480,共4页Journal of Hainan Medical University

基　　金：攀枝花市科技局一般资助项目(2013078902XX)~~

摘　　要：目的:分析重复经颅磁刺激(rTMS)联合度洛西汀在广泛性焦虑障碍患者治疗中的临床价值。方法:将180例广泛性焦虑障碍患者随机分为两组,对照组和观察组各90例。对照组采用度洛西汀治疗,观察组则加载重复经颅磁刺激治疗。治疗前后采用汉密尔顿焦虑量表(HAMA)、临床疗效总评量表(CGI)评估疗效,采用脑诱发电位仪检测非匹配负波(MMN)、P300特征,同时对血浆皮质醇、脑源性神经营养因子(BDNF)及同型半胱氨酸(Hcy)水平进行检测,并比较组间差异。结果:经重复测量方差分析,对照组和观察组间HAMA及CGI评分、MMN潜伏期、MMN波幅、N2靶潜伏期、P3靶潜伏期、P2非靶波幅、血浆皮质醇、BDNF、Hcy水平时间主效应、组间主效应及交互效应均有统计学意义(P<0.05)。结论:rTMS联合度洛西汀治疗广泛性焦虑障碍起效更快,疗效更佳,值得临床推广。Objective： To investigate the clinical effects of repetitive transeranial magnetic stimulation combined with dutoxetine on patients with generalized anxiety disorder. Methods：A total of 180 patients with generalized anxiety disorder were randomly divided into control group and observation group with 90 cases in each group. Patients in the control group were trea- ted with dutoxetine, while those in the observation group were treated with repetitive transcranial magnetic stimulation. Then the Hamilton Anxiety Scale （HAMA）. Clinical Global Impression Scale （CGI） were used to evaluate the efficacy before and af- ter treatment, then the characteristics of non matched negative wave （MMN） and P300 were detected by using brain evoked potential, and plasma cortisol, brain derived neurotrophic factor （BDNF） and homocysteine （Hcy） levels were detected and compared too. Results：Analysis of variance of repeated measurement showed significant differences in HAMA and CGI scores, MMN latency, MMN amplitude, N2 target latency, P3 target latency, P2 non target amplitude, plasma levels of eortisol, BD- NF and Hcy main effect, main effects and interaction effects between the two groups （P all 〈0.05）. Conclusion： Repetitive transcranial magnetic stimulation combined with dutoxetine shows quicker and better effects for patients with generalized anxie- ty disorder than dutoxetine alone, it is worthy of application in large scale.

关 键 词：广泛性焦虑障碍 度洛西汀 重复经颅磁刺激(rTMS) 神经电生理 

分 类 号：R749[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]