难治性抑郁症的治疗进展  

Research progress of the therapy in treatment-resistant depression

作　　者：岳秀宁 刘正福 叶兰仙[1] 王霁阳 任丽娜[1] 张珊珊[1] 

机构地区：[1]兰州大学第二医院心理卫生科,兰州730030 [2]甘肃省临洮县医院神经精神科,定西730500

出　　处：《中华行为医学与脑科学杂志》2016年第3期280-284,共5页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：难治性抑郁症是一种常见的、严重的精神疾病，与重大疾病负担相关。大多数患者接受传统抗抑郁药物治疗后不能获得症状缓解，因此对临床医生而言仍是精神医学面临的难题之一。通过归纳总结近年来国内外关于难治性抑郁症治疗的研究，提示目前该病的疗效仍不容乐观，但其治疗取得很大进展。目前常用的治疗方法有新型快速抗抑郁药、具有抗抑郁作用的其他药物、心理治疗、电休克治疗、经颅磁刺激、磁共振引导下聚焦超声术、深部脑刺激、有氧运动、光照疗法等，每种治疗策略均有其优缺点和特殊的研究价值。一线治疗策略的高度未缓解率使得安全性较高的新型抗抑郁药、具有抗抑郁作用的其他药物与非药物治疗手段相结合成为治疗难治性抑郁症未来发展的方向。Treatment resistant depression is a common and severe mental disorder associated with significant burden of disease .Most individuals receiving conventional pharmacotheraphy fail to achieve and sustain remission.So this is still one of the difficult challenges for the psychiatrist .Much of the research pro-vided indications that the efficacy of treatment for the disease was not optimistic, but the treatment was still made great progress .The common treatments for this disease included pharmacotherapy,psychotherapy,elec-troconvulsive therapy（ECT）,transcranial magnetic stimulation （TMS）,magnetic resonance guided focused ultrasound surgery（ MRgFUS） ,deep brain stimulation （ DBS） ,aerobic exercise,light therapy and so on.Each therapeutic strategy has its own features, and could be suitable or unsuitable in some situations.The high rates of non-remission with first-line treatment strategies make the combination of antidepressant and non-drug treatments to be the new trend of the treatments for treatment resistant depression in the future.

关 键 词：难治性抑郁症 药物治疗 非药物治疗 

分 类 号：R749.4[医药卫生—神经病学与精神病学]