重复经颅磁刺激联合帕罗西汀治疗创伤后应激障碍的效果观察  

Effect of repetitive transcranial magnetic stimulation( rTMS ) combined with paroxetine in the treatment of post-traumatic stress disorder

作　　者：周平[1] 张瑶[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》2016年第2期89-92,共4页Journal of Psychiatry

基　　金：国家自然科学基金资助项目(编号:30870886)

摘　　要：目的观察重复经颅磁刺激(r TMS)联合帕罗西汀对创伤后应激障碍(PTSD)的疗效及安全性。方法将56例PTSD患者随机分为研究组(帕罗西汀联合r TMS治疗)28例和对照组(帕罗西汀治疗)28例,均治疗4周。于治疗前及治疗后第4周末采用创伤后应激障碍检查表(PCL)及汉密尔顿焦虑量表(HAMA)评定。结果两组治疗后第4周末PCL总分评分差及各因子分均较各自治疗前降低(P<0.05),研究组PCL总分评分差及各因子评分差均高于对照组(P<0.05);治疗后第4周末两组HAMA评分均较各自治疗前低(P<0.05),研究组HAMA评分低于对照组(P<0.05);两组间总不良反应发生率比较差异无统计学意义(P>0.05)。结论联用r TMS能够增加帕罗西汀对PTSD的重现、回避、高警觉核心症状以及焦虑症状的疗效。Objective To observe the effect and safety of repetitive transcranial magnetic stimulation（ r TMS） combined with paroxetine in the treatment of post-traumatic stress disorder（ PTSD）. Methods 56 patients with PTSD were randomized into study group（ 28 cases） treated with r TMS combined with paroxetine and control group（ 28 cases） treated with paroxetine monotherapy for 4 weeks. All patients in both groups were assessed with PTSD Checklist（ PCL） and Hamilton Anxiety Rating Scale（ HAMA） at baseline and at the end of the treatment. Results At the end of the 4-week treatment,total score and all factor scores of PCL in both groups decreased significantly when compared with the baseline（ P〈0. 05）. The decrease of total score and all factor scores of PCL in study group were significantly higher than those in control group（ P〈0. 05）. At the end of the treatment,total scores of HAMA in both groups were significantly lower than the baseline（ P〈0. 05）,and total score of HAMA in study group was significantly lower than that in control group（ P〈0. 05）. No significant difference was found in incidence rate of side effects between the two groups（ P〈0. 05）. Conclusion Combination with r TMS can enhance the effect of paroxetine on symptoms of flash-back,evasion,hyperarousal and anxiety in PTSD.

关 键 词：重复经颅磁刺激 帕罗西汀 创伤后应激障碍 

分 类 号：R749.94[医药卫生—神经病学与精神病学]