低频重复经颅磁刺激联合帕罗西汀治疗伴焦虑症状抑郁障碍患者疗效观察  

Efficacy of paroxetine combined with the low frequency repetitive transcranial magnetic stimulation in the treatment of depressive disorder patients with anxiety symptoms

作　　者：吕婷婷[1] 王新友[2] 王长虹[1] 

机构地区：[1]新乡医学院第二附属医院,河南新乡453002 [2]新乡医学院第二附属医院精神科,河南新乡453002

出　　处：《新乡医学院学报》2016年第7期589-592,共4页Journal of Xinxiang Medical University

基　　金：河南省基础与前沿技术研究计划项目(编号:142300410025);新乡医学院高层次人才科研资助项目(编号:08BSKYQD-004);新乡医学院科研培育基金资助项目(编号:2013ZD117);新乡医学院研究生科研创新支持计划资助项目(编号:YJSCX201243Y;YJSCX20420Y);河南省科技攻关计划项目(编号:112102310211)

摘　　要：目的探讨低频重复经颅磁刺激(r TMS)联合帕罗西汀治疗伴有焦虑症状抑郁障碍患者的疗效及安全性。方法将伴有焦虑症状的抑郁障碍患者90例随机分为帕罗西汀+r TMS治疗组(A组)、帕罗西汀+伪r TMS治疗组(B组)和帕罗西汀治疗组(C组)。3组患者均接受6周帕罗西汀(10 mg·d-1)治疗,在此基础上,A组患者接受右侧前额叶背外侧r TMS刺激(1 Hz),刺激时间15 s,间歇5 s,每周5次,连续6周。B组患者应用的刺激线圈、刺激部位、次数、频率与A组相同,但只有振动声音,不产生磁场效应。于治疗前和治疗第2、4、6周末采用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评价疗效。结果治疗6周末3组患者治疗总有效率比较差异均无统计学意义(P>0.05)。治疗前3组患者HAMD、HAMA评分比较差异均无统计学意义(P>0.05)。治疗2周末,A、B组患者HAMD和HAMA评分低于C组(P<0.05);A组与B组患者HAMD、HAMA评分比较差异无统计学意义(P>0.05)。治疗4周末,A组患者HAMD评分低于B、C组(P<0.05),B组与C组患者HAMD比较差异无统计学意义(P>0.05);A组患者HAMA评分低于C组(P<0.05),B组患者与A、C组比较差异无统计学意义(P>0.05)。治疗6周末,A组患者HAMD、HAMA评分低于B、C组(P<0.05),B组与C组患者HAMD、HAMA比较差异无统计学意义(P>0.05)。治疗期间3组患者均未发生严重不良反应。A、B、C组患者不良反应发生率分别为35.7%(10/28)、41.4%(12/29)、50.0%(14/28),3组不良反应发生率比较差异无统计学意义(P>0.05)。结论低频r TMS联合帕罗西汀治疗伴焦虑症状抑郁障碍患者有效率高,且不良反应少。Objective To observe the efficacy and safety of paroxetine combined with low frequency repetitive transcranial magnetic stimulation（ r TMS） for treatment of the depressive disorder patients with anxiety symptoms. Methods Ninety depressive disorder patients with anxiety symptoms were randomly divided into the paroxetine combined with r TMS group（ group A）,paroxetine combined with unreal r TMS group（ group B） and paroxetine group（ group C）. All patients were given paroxetine（ 10 mg·d- 1） for six weeks; based on this,the patients in group A were given r TMS（ 1 Hz,stimulating 15 s and interval 5 s） on the right dorsolateral prefrontal for 20 min,5 times per week for six weeks; and the patients in group B were given unreal stimulation which was the same with the group A in the coil,site of stimulation,number,frequency; however,without any magnetic field. Hamilton Depression Rating Scale（ HAMD） and Hamilton Anxiety Rating Scale（ HAMA） were used to assess the efficacy before treatment and 2,4,6 weeks after treatment. Results There was no statistic difference of the effectiveness rate of patients at the 6 weeks after treatment among the three groups（ P〉0. 05）. There was no statistic differences of the HAMD and HAMA scores before treatment among the three groups（ P〉0. 05）. At the end of the 2ndweeks,the HAHA and HAMD scores of patients in group A and group B were significantly lower than those in group C（ P〈0. 05）; but there was no statistic difference of the HAHA and HAMD scores between group A and group B（ P〈0. 05）. At the end of the 4thweeks,the HAMD scores of patients in group A were significantly lower than those in group B and group C（ P〈0. 05）; there was no statistic difference of the HAMD scores between group B and group C（ P〈0. 05）; the HAMA scores of patients in group A were significantly lower than those in group C（ P〈0. 05）; there was no statistic difference of the HAMA scores between the group B and group A,group C（ P〈0. 05）. At

关 键 词：重复经颅磁刺激 帕罗西汀 焦虑 抑郁 

分 类 号：R749.059[医药卫生—神经病学与精神病学]